NPIMap

Individual provider Active NPI

Roberto Pabalate, MD

  • Family Medicine Physician
  • Forsyth, IL
National Provider Identifier
1528221504
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036127240 Issued in IL
Practice address
241 W Weaver Rd Ste 240
Forsyth, IL 62535-9770
Phone
(217) 876-3780
Fax
(217) 876-3790
NPI assigned
Jul 9, 2008
Last updated
Apr 4, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036127240 IL Primary

Addresses

Primary practice location

241 W Weaver Rd Ste 240
Forsyth, IL 62535-9770

Mailing address

PO Box 3428
Springfield, IL 62708-3428
Phone (217) 876-8121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110826000688 IL Practitioner - Family Practice 0446420517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Decatur Memorial HospitalGroup PAC ID 6204731144, 173 clinicians

Practice addresses (Care Compare)

241 W Weaver Rd
Suite 210
Forsyth, IL 62535-9769
Phone (217) 876-6860

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.88 of 100Reported as group
Quality
63.91
Improvement activities
40
Cost
77.03

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue11
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036127240ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Decatur Memorial Hospital Family Medicine CurrentSince Jul 25, 2011 Accepting new patients
Springfield Clinic LLP Current Accepting new patients
Memorial Health Partners Family Medicine Current Accepting new patients
Decatur Memorial Hospital CurrentSince Jul 25, 2011 Accepting new patients

Locations

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

2300 N Edward St
Ofc
Decatur, IL 62526
Phone (217) 876-8121

302 W Hay St
#110
Decatur, IL 62526

330 N Wyckles Rd
Decatur, IL 62522
Phone (217) 429-9700

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

241 W Weaver Rd
Ste 145D
Forsyth, IL 62535
Phone (217) 876-5200

241 W Weaver Rd
Ste 210
Forsyth, IL 62535
Phone (217) 876-5600

241 W Weaver Rd
Ste 240
Forsyth, IL 62535
Phone (217) 876-5290

Interoperability endpoints

  • Direct secure messaging: robertopabalate@memorial.allscriptsdirect.net
  • Direct secure messaging: robertopabalate@sfc.allscriptsdirect.net

Organizations & group practices 4

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 6

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": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1528221504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3428",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627083428",
            "telephone_number": "217-876-8121",
            "fax_number": "217-876-2249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 W WEAVER RD STE 240",
            "city": "FORSYTH",
            "state": "IL",
            "postal_code": "625359770",
            "telephone_number": "217-876-3780",
            "fax_number": "217-876-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PABALATE",
        "first_name": "ROBERTO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-09",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036127240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forsyth, IL

Sources for this page

Verify at the official NPI Registry.