Individual provider Active NPI

Christopher Hastings Gram, MD

  • Vascular Surgery Physician
  • Decatur, IL
National Provider Identifier
1528040219
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
036111330 Issued in IL
Practice address
1800 E Lake Shore Dr
Decatur, IL 62521-3810
Phone
(217) 464-1722
Fax
(217) 464-1717
NPI assigned
Nov 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 036111330 IL Primary

Addresses

Primary practice location

1800 E Lake Shore Dr
Decatur, IL 62521-3810

Mailing address

1800 E Lake Shore Dr
Decatur, IL 62521-3810
Phone (217) 464-1722

Other identifiers 2

IdentifierTypeStateIssuer
036111330MedicaidIL
CI8411OtherMEDICARE TRAVELERS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cgram100884@ewd.direct.hshs.org Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040701001435 IL Practitioner - Vascular Surgery 3375520844 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Massachusetts Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1800 E Lake Shore Dr
St Marys
Decatur, IL 62521-3883
Phone (217) 464-2870

503 N Maple St
Effingham, IL 62401-2006
Phone (217) 342-2121

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)38
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036111330ILMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Decatur Memorial Hospital CurrentSince Nov 27, 2017 Accepting new patients
Decatur Memorial Hospital CurrentSince Nov 27, 2017 Accepting new patients
St Anthonys Memorial Hospital of the Hospital Sisters of the Third CurrentSince Jan 5, 2025 Accepting new patients
St Anthonys Memorial Hospital of the Hospital Sisters of the Third CurrentSince Jan 5, 2025 Accepting new patients
Prairie Cardiovascular Consultants LTD Vascular Surgery CurrentSince Sep 1, 2021 Accepting new patients
Jordan Physician Associates, Inc. Vascular Surgery Past Accepting new patients
Jordan Physician Associates, Inc. Past Accepting new patients
Heritage Behavioral Health Center, Inc. PastSince Sep 1, 2021 Accepting new patients
HSHS Medical Group Inc Past Accepting new patients

Locations

1800 E Lake Shore Dr
Decatur, IL 62521
Phone (217) 464-2729

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

2965 N Main St
Ste D
Decatur, IL 62526
Phone (217) 422-6100

1 Memorial Dr
Ste 300
Decatur, IL 62526
Phone (217) 428-6300

503 N Maple St
Effingham, IL 62401
Phone (217) 342-2121

241 W Weaver Rd
Ste 145B
Forsyth, IL 62535
Phone (217) 876-5220

619 E Mason St
Ste 4P57
Springfield, IL 62701

619 E Mason St
#4P57
Springfield, IL 62701

619 E Mason St
Ste 4
Springfield, IL 62701

Organizations & group practices 9

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 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": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1528040219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 E LAKE SHORE DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213810",
            "telephone_number": "217-464-1722",
            "fax_number": "217-464-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E LAKE SHORE DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213810",
            "telephone_number": "217-464-1722",
            "fax_number": "217-464-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAM",
        "first_name": "CHRISTOPHER",
        "middle_name": "HASTINGS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036111330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036111330",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TRAVELERS",
            "identifier": "CI8411",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cgram100884@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1800 E Lake Shore Dr",
            "city": "Decatur",
            "state": "IL",
            "country_code": "US",
            "postal_code": "625213810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.