Individual provider Active NPI

Dominic Giafagleone Ryaddigan, LCSW

  • Clinical Social Worker
  • Springfield, IL
National Provider Identifier
1437802915
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.023139 Issued in IL
Practice address
3225 Hedley Rd
Springfield, IL 62711-6248
Phone
(217) 726-7300
Fax
(217) 726-5989
NPI assigned
Feb 3, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.023139 IL Primary

Addresses

Primary practice location

3225 Hedley Rd
Springfield, IL 62711-6248

Mailing address

3225 Hedley Rd
Springfield, IL 62711-6248
Phone (217) 726-7300

Other identifiers 1

IdentifierTypeStateIssuer
149023139OtherILLCSW

Other names 1

  • Dominic M.C. Giafagleone Former name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220221000385 IL Practitioner - Clinical Social Worker 8628462405

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.44 of 100Reported as group
Quality
71.79
Promoting interoperability
77
Improvement activities
40
Cost
75.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.023139ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Physician Services Clinical CurrentSince Feb 14, 2022 Accepting new patients
Memorial Physician Services CurrentSince Feb 14, 2022 Accepting new patients
Memorial Physician Services Current Accepting new patients
Family Medical Center of Chatham, LLC Current Accepting new patients

Locations

101 E Plummer Blvd
Chatham, IL 62629
Phone (217) 483-3487

3225 Hedley Rd
Springfield, IL 62711
Phone (217) 726-6700

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": "1643846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1437802915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 HEDLEY RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627116248",
            "telephone_number": "217-726-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 HEDLEY RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627116248",
            "telephone_number": "217-726-7300",
            "fax_number": "217-726-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYADDIGAN",
        "first_name": "DOMINIC",
        "middle_name": "GIAFAGLEONE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-03",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.023139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "149023139",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOMINIC",
            "last_name": "GIAFAGLEONE",
            "middle_name": "M.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.