Individual provider Active NPI

Mary E Royce, ACNP-BC

  • Acute Care Nurse Practitioner
  • Springfield, IL
National Provider Identifier
1508070442
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
209-005642 Issued in IL
Practice address
1025 S 6TH St
Springfield, IL 62703-2403
Phone
(217) 528-7541
NPI assigned
May 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209-005642 IL Primary

Addresses

Primary practice location

1025 S 6TH St
Springfield, IL 62703-2403

Mailing address

1025 S 6TH St
Springfield, IL 62703-2499
Phone (217) 528-7541

Other practice location 1

751 N Rutledge St
Ste 2300
Springfield, IL 62702-4909
Phone (217) 545-8507

Other names 1

  • Mary E Haskell Former name

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080618000491 IL Practitioner - Nurse Practitioner 5597707893 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • Memorial Medical Center Hospital, Springfield, IL, CCN 140148

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as apm
Quality
75.65
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209-005642ILMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Clinic LLP Current Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Jun 29, 2009 Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Jun 29, 2009 Accepting new patients
Springfield Clinic, LLP CurrentSince Jan 25, 2021 Accepting new patients
University of Penn-PA Trauma Past Accepting new patients

Locations

101 E Plummer Blvd
Chatham, IL 62629
Phone (217) 483-3487

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

1025 S 6th St
Springfield, IL 62703

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

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

751 N Rutledge St
Ste 2300
Springfield, IL 62702
Phone (217) 545-3821

301 N 8th St
Springfield, IL 62701
Phone (217) 545-0003

Interoperability endpoints

  • Direct secure messaging: maryroyce@sfc.allscriptsdirect.net
  • Direct secure messaging: mary.royce.1@28977.direct.athenahealth.com

Organizations & group practices 5

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

Hospital & facility affiliations 1

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1508070442",
    "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",
            "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": "627032403",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 N Rutledge St",
            "address_2": "STE 2300",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627024909",
            "country_code": "US",
            "telephone_number": "217-545-8507",
            "fax_number": "217-545-8163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROYCE",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209-005642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "HASKELL",
            "middle_name": "E",
            "credential": "ACNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.