Praveen K Mullangi, M.D.
Individual provider Active NPI Infectious Disease Physician · Springfield, IL
NPI 1508056987 · NPPES record last updated May 21, 2020
Key facts
- NPI
- 1508056987
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Infectious Disease Physician 207RI0200X
- License
- 036120667 (IL)
- Practice address
- 301 N 8TH St
Springfield, IL 62701-1041 - Phone
- (217) 528-7541
- NPI assigned
- Jul 31, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 23
Hospital & facility affiliations 6
Owned or controlled facilities with NPI records 5
Medicare Care Compare profile
- Specialty
- Infectious Disease
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Springfield Clinic, LLP
Practice addresses (Care Compare)
800 N 1St St
Springfield, IL 62702-3719
Phone (217) 528-7541
Hospital & facility affiliations
- Enhabit Home Health
- Memorial Medical Center
- St Johns Hospital
- Abraham Lincoln Memorial Hospital
- Jacksonville Memorial Hospital
- Taylorville Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.83 of 100
- Quality
- 75.65
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 28 |
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 5
| Facility | Type | Role | Since |
|---|---|---|---|
| Springfield Clinic Lincoln Rural Health |
Rural health clinic | Limited Partnership Interest | Jan 1, 2017 |
| Springfield Clinic Nokomis Rural Health |
Rural health clinic | Limited Partnership Interest | Jan 1, 2017 |
| Springfield Clinic Raymond Rural Health |
Rural health clinic | Limited Partnership Interest | Jan 1, 2017 |
| Springfield Clinic Neoga Rural Health |
Rural health clinic | Limited Partnership Interest | Jan 1, 2017 |
| Springfield Clinic, LLP |
Rural health clinic | Limited Partnership Interest | Jan 1, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080829000554 | IL | Practitioner - Infectious Disease |
5294801163 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036120667 | IL | MD | Infectious Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Springfield Clinic, LLP | Current |
Accepting new patients |
Locations
301 N 8th St
Springfield, IL 62701
Phone (217) 545-0003
800 N 1st St
Springfield, IL 62702
301 N 8th St
Ste 1
Springfield, IL 62701
900 N 1st St
Springfield, IL 62702
901 N 1st St
Springfield, IL 62702
Phone (217) 588-2660
1025 S 6th St
Springfield, IL 62703
775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300
Interoperability endpoints
- praveen.mullangi.1@28977.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | 036120667 | IL | Yes |
Addresses
Primary practice location
301 N 8TH St
Springfield, IL 62701-1041
Mailing address
1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036120667 | Medicaid | IL | |
| R02610 | Other | IL | MEDICARE PTAN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | praveenmullangi@sfc.allscriptsdirect.net |
NPI Registry JSON
{
"created_epoch": "1185840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590019200000",
"number": "1508056987",
"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": "301 N 8TH ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627011041",
"telephone_number": "217-528-7541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLANGI",
"first_name": "PRAVEEN",
"middle_name": "K",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-31",
"last_updated": "2020-05-21",
"certification_date": "2020-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "IL",
"license": "036120667",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036120667",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "R02610",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "praveenmullangi@sfc.allscriptsdirect.net",
"affiliation": "N",
"address_1": "301 N 8th St",
"city": "Springfield",
"state": "IL",
"country_code": "US",
"postal_code": "627011041",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Springfield, IL
- Casey Muehle
- Julie A. Mueller
- Basanti Mukerji
- Vaskar Mukerji
- Shalini Mulkanoor
- Eva C Muller
- Richard Mulligan
- James C Mullin
- Alexandria Rose Mullink
- Barry T Mulshine
All providers in Springfield, IL · Infectious Disease Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.