Individual provider Active NPI

Prasad B Patel, M.D.

  • Diagnostic Radiology Physician
  • Springfield, IL
National Provider Identifier
1487919502
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
125062050 Issued in IL
Practice address
1025 S 6TH St
Springfield, IL 62703-2403
Phone
(217) 528-7541
NPI assigned
Jul 5, 2012
Last updated
Mar 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2018-00512 NC
Diagnostic Radiology Physician 2085R0202X 125062050 IL Primary

Addresses

Primary practice location

1025 S 6TH St
Springfield, IL 62703-2403

Mailing address

1025 S 6TH St
Springfield, IL 62703-2499

Other practice location 1

3186 Village Dr Ste 201
Fayetteville, NC 28304-3979
Phone (910) 486-5700

Other practice location 2

355 Ridge Ave
Evanston, IL 60202-3328
Phone (847) 316-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, IL, NY, NJ4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20180622001799 NC Practitioner - Diagnostic Radiology 6002161601 Reassigns benefits to 4 organizations
I20210806000873 IL Practitioner - Diagnostic Radiology 6002161601 Reassigns benefits to 1 organization
I20250416001292 NY Practitioner - Diagnostic Radiology 6002161601 Reassigns benefits to 1 organization
I20251110004032 NJ Practitioner - Diagnostic Radiology 6002161601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Rush Medical College of Rush University, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians
Garden State Healthcare Associates LLCGroup PAC ID 8426190687, 171 clinicians

Practice addresses (Care Compare)

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

176 Palisade Ave
Jersey City, NJ 07306-1121
Phone (201) 795-8200

200 Stahlhut Dr 1St Floor Room
Suite 428
Lincoln, IL 62656-5066
Phone (217) 605-5309

201 E Pleasant St
Taylorville, IL 62568-1562
Phone (217) 824-3566

565 White Oak Pond Rd
Apex, NC 27523-8035
Phone (217) 528-7541

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

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

7901 Broadway
Elmhurst, NY 11373-1329
Phone (718) 334-4952

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
333973NYMDLicensed Practical Nurse
125062050ILMDDiagnostic Radiology Physician
2018-00512NCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Radiology P a Diagnostic Radiology CurrentSince Jul 1, 2019 Accepting new patients
Medical Imaging Center, LLC CurrentSince Apr 1, 2019 Accepting new patients
Bladen Healthcare LLC CurrentSince Jul 1, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai Diagnostic Radiology CurrentSince Feb 6, 2025 Accepting new patients
Garden State Healthcare Associates, LLC CurrentSince Mar 26, 2024 Accepting new patients
Springfield Clinic, LLP CurrentSince Jul 20, 2021 Accepting new patients
Bladen Healthcare LLC CurrentSince Jul 1, 2019 Accepting new patients

Locations

1025 S 6th St
Springfield, IL 62703

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

501 S Poplar St
Elizabethtown, NC 28337
Phone (910) 862-4043

3186 Village Dr
Ste 201
Fayetteville, NC 28304
Phone 9104865700104

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

176 Palisade Ave
Jersey City, NJ 07306
Phone (201) 795-8200

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-4951

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: prasad.patel.1@28977.direct.athenahealth.com

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 Oct 1, 2023
Springfield Clinic Nokomis Rural HealthNokomis, IL, CCN 783814 Rural health clinic Limited Partnership Interest Oct 1, 2023
Springfield Clinic Raymond Rural HealthRaymond, IL, CCN 783829 Rural health clinic Limited Partnership Interest Oct 1, 2023
Springfield Clinic Neoga Rural HealthNeoga, IL, CCN 783812 Rural health clinic Limited Partnership Interest Oct 1, 2023
Springfield Clinic, LLPMacomb, IL, CCN 783855 Rural health clinic Limited Partnership Interest Oct 1, 2023

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 8

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 5

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": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1487919502",
    "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": "627032499"
        },
        {
            "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": "627032403",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3186 Village Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043979",
            "country_code": "US",
            "telephone_number": "910-486-5700",
            "fax_number": "910-486-5950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "355 Ridge Ave",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602023328",
            "country_code": "US",
            "telephone_number": "847-316-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRASAD",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-05",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2018-00512",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "125062050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.