Marc R. Dejong, MD

Primary specialty

Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X

License

036114259 Issued in IL

Practice address

800 N 1St St
Springfield, IL 62702-3719

Phone

(217) 528-7541

Fax

(217) 527-1103

NPI assigned

Sep 23, 2005

Last updated

May 22, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Sports MedicineAlso: Internal Medicine

Education

Vanderbilt University School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Medical Center Hospital, Springfield, IL, CCN 140148
• St Johns Hospital Hospital, Springfield, IL, CCN 140053

Merit-based Incentive Payment System (MIPS)

Final score

88.83 of 100Reported as apm

Quality

75.65

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marc.dejong.1@28977.direct.athenahealth.com

All facility ownership & control disclosures 5

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

Owned or controlled facilities with NPI records 5

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

• Springfield Clinic LLP

  • Rural Health Clinic/Center
  • Raymond, IL
  • NPI 1013255942

  Limited Partnership Interest

  CMS ownership
• Springfield Clinic LLP

  • Rural Health Clinic/Center
  • Macomb, IL
  • NPI 1730831157

  Limited Partnership Interest

  CMS ownership
• Springfield Clinic LLP

  dba Springfield Clinic Rural Health Neoga

  • Rural Health Clinic/Center
  • Neoga, IL
  • NPI 1972790889

  Limited Partnership Interest

  CMS ownership
• Springfield Clinic, LLP

  • Rural Health Clinic/Center
  • Lincoln, IL
  • NPI 1518143452

  Limited Partnership Interest

  CMS ownership
• Springfield Clinic, LLP

  • Rural Health Clinic/Center
  • Nokomis, IL
  • NPI 1922285600

  Limited Partnership Interest

  CMS ownership

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.

• Springfield Clinic, LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1780638478
  Medicare reassignment Care Compare group NPD

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

• Memorial Medical Center

  • General Acute Care Hospital
  • Springfield, IL
  • NPI 1255317590
  Care Compare affiliation
• St Johns Hospital of the Hospital Sisters of the Third Order of St F

  dba HSHS St. John's Hospital

  • General Acute Care Hospital
  • Springfield, IL
  • NPI 1205818481
  Care Compare affiliation

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1477549541",
    "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",
            "fax_number": "217-528-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023719",
            "telephone_number": "217-528-7541",
            "fax_number": "217-527-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJONG",
        "first_name": "MARC",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036114259",
            "primary": false
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "IL",
            "license": "036114259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Gene Deeke, RPH
• Chad Joseph Defrain, MD
• Quinlan Mae Degroot, FNP-BC
• Keelan C. Dehart, NNP-BC
• Elizabeth Deitemyer
• Jonathan E. Dela Cruz, M.D.
• Marthe K.P. Dela Cruz, M.D.
• Olivia Ann Delay, FNP-C
• Diane Deleonardo, LCSW
• Mia Elise Delgado

• Sports Medicine (Internal Medicine) Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Sports Medicine (Internal Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.