NPIMap

Individual provider Active NPI

Tina M Rozene, M.D.

  • Pediatrics Physician
  • Effingham, IL
National Provider Identifier
1467489807
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036094764 Issued in IL
Practice address
300 N Maple St
Effingham, IL 62401-2003
Phone
(217) 342-4151
Fax
(217) 347-0108
NPI assigned
Jun 28, 2006
Last updated
May 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036094764 IL
Pediatrics Physician 208000000X 036094764 IL Primary

Addresses

Primary practice location

300 N Maple St
Effingham, IL 62401-2003

Mailing address

1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541

Other identifiers 5

IdentifierTypeStateIssuer
036094764MedicaidIL
054508OtherILHEALTH ALLIANCE #
2523659OtherILBC/BS #
386900OtherILHEALTHLINK #
370012295OtherILRAILROAD MEDICARE/PALMETTO GBA

Other names 1

  • Tina M Schrader Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tinarozene@sfc.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050211000237 IL Practitioner - Pediatric MedicinePractitioner - Internal Medicine 9739140294 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
Southern Illinois University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians
Marshall Clinic Effingham S CGroup PAC ID 1052372513, 14 clinicians

Practice addresses (Care Compare)

300 N Maple
Effingham, IL 62401-2003
Phone (217) 528-7541

300 N Maple St PO Box
Suite 1268
Effingham, IL 62401-2003

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036094764ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Clinic, LLP CurrentSince Jan 1, 2016 Accepting new patients
Marshall Clinic Effingham, S.C. Internal Medicine Current Accepting new patients

Locations

300 N Maple St
Effingham, IL 62401
Phone (217) 342-4151

507 W Washington St
Newton, IL 62448
Phone (217) 606-3004

1025 S 6th St
Springfield, IL 62703

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Springfield Clinic Lincoln Rural HealthLincoln, IL, CCN 143925 Rural health clinic Limited Partnership Interest Jan 1, 2016
Springfield Clinic Nokomis Rural HealthNokomis, IL, CCN 783814 Rural health clinic Limited Partnership Interest Jan 1, 2016
Springfield Clinic Raymond Rural HealthRaymond, IL, CCN 783829 Rural health clinic Limited Partnership Interest Jan 1, 2016
Springfield Clinic Neoga Rural HealthNeoga, IL, CCN 783812 Rural health clinic Limited Partnership Interest Jan 1, 2016
Springfield Clinic, LLPMacomb, IL, CCN 783855 Rural health clinic Limited Partnership Interest Jan 1, 2016

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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

Hospital & facility affiliations 12

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1467489807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N MAPLE ST",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012003",
            "telephone_number": "217-342-4151",
            "fax_number": "217-347-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZENE",
        "first_name": "TINA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036094764",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036094764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036094764",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE #",
            "identifier": "054508",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS #",
            "identifier": "2523659",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK #",
            "identifier": "386900",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE/PALMETTO GBA",
            "identifier": "370012295",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tinarozene@sfc.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "300 N Maple St",
            "city": "Effingham",
            "state": "IL",
            "country_code": "US",
            "postal_code": "624012003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "SCHRADER",
            "middle_name": "M",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Effingham, IL

Sources for this page

Verify at the official NPI Registry.