NPIMap

Individual provider Active NPI

Kwaku Opoku, MD

  • Vascular & Interventional Radiology Physician
  • Springfield, IL
National Provider Identifier
1477059186
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
036169498 Issued in IL
Practice address
1025 S 6TH St
Springfield, IL 62703-2499
Phone
(217) 528-7541
NPI assigned
Apr 2, 2018
Last updated
Jul 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 036169498 IL Primary
Diagnostic Radiology Physician 2085R0202X 036169498 IL
Student in an Organized Health Care Education/Training Program 390200000X TX

Addresses

Primary practice location

1025 S 6TH St
Springfield, IL 62703-2499

Mailing address

PO Box 19248
Springfield, IL 62794-9248
Phone (217) 528-7541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240730003074 IL Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 2365989142 Reassigns benefits to 6 organizations
I20250910002356 PA Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 2365989142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Texas Tech University Health Science Center School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians
Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians
Specialists in Medical Imaging SCGroup PAC ID 2163733544, 228 clinicians

Practice addresses (Care Compare)

100 Stahlhut Dr
Lincoln, IL 62656-5059
Phone (217) 735-9555

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

1600 W Walnut St
Jacksonville, IL 62650-1136
Phone (217) 245-9541

350 W Carpenter St
Springfield, IL 62702-4902
Phone (217) 525-0210

701 N 1St St
Springfield, IL 62781-0001
Phone (217) 528-7541

740 High St
Suite 3001
Williamsport, PA 17701-3111
Phone (570) 321-2805

7402 E Riverside Blvd
Loves Park, IL 61111-5630
Phone (309) 671-8282

775 Engineering Ave
Springfield, IL 62703-5909
Phone (217) 522-4300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036169498ILMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Susquehanna Physician Services CurrentSince Jul 1, 2025 Accepting new patients
Good Samaritan Regional Health Center CurrentSince Feb 3, 2026 Accepting new patients
Good Samaritan Regional Health Center Diagnostic Radiology CurrentSince Feb 3, 2026 Accepting new patients
St. Mary's Hospital, Centralia, Illinois CurrentSince Feb 3, 2026 Accepting new patients
St. Mary's Hospital, Centralia, Illinois Diagnostic Radiology CurrentSince Feb 3, 2026 Accepting new patients
Springfield Clinic, LLP CurrentSince Aug 1, 2024 Accepting new patients
Specialists in Medical Imaging SC Diagnostic Radiology CurrentSince Jan 5, 2026 Accepting new patients
Susquehanna Physician Services Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients

Locations

7402 E Riverside Blvd
Loves Park, IL 61111
Phone (815) 226-9642

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

1025 S 6th St
Springfield, IL 62703

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

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

700 High St
Williamsport, PA 17701
Phone (570) 321-2000

740 High St
Ste 3001
Williamsport, PA 17701
Phone (570) 321-2805

Interoperability endpoints

  • Direct secure messaging: kwaku.opoku.1@28977.direct.athenahealth.com

Organizations & group practices 10

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1477059186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19248",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949248",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032499",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPOKU",
        "first_name": "KWAKU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IL",
            "license": "036169498",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036169498",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.