Individual provider Active NPI

Drake Gashkoff, M.D.

  • Family Medicine Physician
  • Jacksonville, IL
National Provider Identifier
1558716274
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.156455 Issued in IL
Practice address
15 Founders LN Ste 100
Jacksonville, IL 62650-3924
Phone
(217) 243-0300
NPI assigned
May 2, 2016
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 036.156455 IL Primary

Addresses

Primary practice location

15 Founders LN Ste 100
Jacksonville, IL 62650-3924

Mailing address

PO Box 3428
Springfield, IL 62708-3428
Phone (217) 243-0300

Other identifiers 1

IdentifierTypeStateIssuer
036156455OtherILMD LICENSE

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
I20210604001238 IL Practitioner - Family Practice 0042575409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Physician ServicesGroup PAC ID 9032005681, 161 clinicians

Practice addresses (Care Compare)

15 Founders St
Suite 100
Jacksonville, IL 62650-3918
Phone (217) 243-0300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.44 of 100Reported as group
Quality
71.79
Promoting interoperability
77
Improvement activities
40
Cost
75.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.156455ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Physician Services Family Medicine CurrentSince Jun 1, 2022 Accepting new patients
Family Medical Center of Chatham, LLC Family Medicine Current Accepting new patients
Memorial Physician Services CurrentSince Jun 1, 2022 Accepting new patients
Springfield Clinic LLP Current Accepting new patients
Memorial Physician Services Family Medicine Current Accepting new patients
Memorial Health Partners Family Medicine Current Accepting new patients
Memorial Expresscare, LLC Family Medicine Past Accepting new patients

Locations

8460 Saint Lukes Dr
Beardstown, IL 62618
Phone (217) 323-2707

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

15 Founders Ln
Ste 100
Jacksonville, IL 62650
Phone (217) 243-0300

Interoperability endpoints

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

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1462147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1558716274",
    "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": "217-243-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 FOUNDERS LN STE 100",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626503924",
            "telephone_number": "217-243-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASHKOFF",
        "first_name": "DRAKE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-02",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.156455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "036156455",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, IL

Sources for this page

Verify at the official NPI Registry.