Individual provider Active NPI

Teresa A. Fesen, FNP-BC

  • Family Nurse Practitioner
  • Springfield, IL
National Provider Identifier
1437402575
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209009955 Issued in IL
Practice address
751 N Rutledge St
Suite 0300
Springfield, IL 62702-4968
Phone
(217) 545-8000
Fax
(217) 545-1229
NPI assigned
Oct 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209009955 IL Primary

Addresses

Primary practice location

751 N Rutledge St
Suite 0300
Springfield, IL 62702-4968

Mailing address

751 N Rutledge St
PO Box 19654
Springfield, IL 62702-4968
Phone (217) 545-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address teresafesen@siusm.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130110000617 IL Practitioner - Nurse Practitioner 8022261569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

301 N 8TH St
Springfield, IL 62701-1041
Phone (217) 545-8000

751 N Rutledge St
Springfield, IL 62702-4968
Phone (217) 545-8000

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince May 15, 2017 Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince May 15, 2017 Accepting new patients
Siu Physicians & Surgeons, Inc Past Accepting new patients

Locations

2 Memorial Dr
Fl 1
Decatur, IL 62526
Phone (217) 872-2930

751 N Rutledge St
Ste 300
Springfield, IL 62702

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

301 N 8th St
Springfield, IL 62701
Phone (217) 545-0003

Interoperability endpoints

  • Direct secure messaging: teresafesen@siusm.allscriptsdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1437402575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 N RUTLEDGE ST",
            "address_2": "PO BOX 19654",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024968",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-1229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 N RUTLEDGE ST",
            "address_2": "SUITE 0300",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024968",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FESEN",
        "first_name": "TERESA",
        "middle_name": "A.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-25",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209009955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "teresafesen@siusm.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "751 N Rutledge St",
            "address_2": "Suite 0300",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627024968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.