Individual provider Active NPI

David J. Kiel, M.D.

  • Family Medicine Physician
  • Decatur, IL
National Provider Identifier
1447358726
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-073228 Issued in IL
Practice address
2300 N Edward St
Decatur, IL 62526-4163
Phone
(217) 876-3000
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-073228 IL Primary

Addresses

Primary practice location

2300 N Edward St
Decatur, IL 62526-4163

Mailing address

16 Woodland TRL
Rochester, IL 62563-9555
Phone (217) 820-3121

Other identifiers 1

IdentifierTypeStateIssuer
036073228MedicaidIL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060120000391 IL Practitioner - Family Practice 1658391164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Emergency Department Specialists LTDGroup PAC ID 5193627727, 62 clinicians

Practice addresses (Care Compare)

2300 N Edward St
Decatur, IL 62526-4163
Phone (217) 876-8121

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-073228ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Emergency Department Specialists LTD CurrentSince Aug 1, 2017 Accepting new patients
Taylorville Memorial Hospital PastSince Apr 30, 2003 Accepting new patients

Locations

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

701 N 1st St
Springfield, IL 62781
Phone (217) 788-3100

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1447358726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 WOODLAND TRL",
            "city": "ROCHESTER",
            "state": "IL",
            "postal_code": "625639555",
            "telephone_number": "217-820-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N EDWARD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264163",
            "telephone_number": "217-876-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIEL",
        "first_name": "DAVID",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-073228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036073228",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.