Individual provider Active NPI

Amber Michele Anderson, M.D.

  • Family Medicine Physician
  • Decatur, IL
National Provider Identifier
1568752137
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.135468 Issued in IL
Practice address
2300 N Edward St
Decatur, IL 62526-4192
Phone
(217) 876-8121
NPI assigned
Apr 15, 2011
Last updated
Oct 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 036.135468 IL Primary

Addresses

Primary practice location

2300 N Edward St
Decatur, IL 62526-4192

Mailing address

2300 N Edward St
Decatur, IL 62526-4163
Phone (217) 876-8121

Other practice location 1

500 E 51st St
Chicago, IL 60615-2400
Phone (312) 572-2643

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
I20150304001590 IL Practitioner - Family Practice 2961728274 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Decatur Memorial HospitalGroup PAC ID 6204731144, 173 clinicians

Practice addresses (Care Compare)

2300 N Edward St
Decatur, IL 62526-4163
Phone (217) 876-8121

241 W Weaver Rd
Suite 145B
Forsyth, IL 62535-9766
Phone (217) 876-5220

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.135468ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Decatur Memorial Hospital Family Medicine CurrentSince Oct 1, 2018 Accepting new patients
Taylorville Memorial Hospital CurrentSince Nov 20, 2023 Accepting new patients
Decatur Memorial Hospital CurrentSince Oct 1, 2018 Accepting new patients
Taylorville Memorial Hospital CurrentSince Nov 20, 2023 Accepting new patients
Cook County Current Accepting new patients
Cook County Family Medicine CurrentSince Oct 20, 2014 Accepting new patients
Cook County CurrentSince Oct 20, 2014 Accepting new patients
Pana Community Hospital Association Current Accepting new patients

Locations

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

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

2300 N Edward St
Ste 3200
Decatur, IL 62526
Phone (217) 876-3660

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

101 E 9th St
Pana, IL 62557
Phone (217) 562-2131

201 E Pleasant St
Taylorville, IL 62568
Phone (217) 707-5555

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1302825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1568752137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N EDWARD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264163",
            "telephone_number": "217-876-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N EDWARD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264192",
            "telephone_number": "217-876-8121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 E 51st St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606152400",
            "country_code": "US",
            "telephone_number": "312-572-2643",
            "fax_number": "312-572-2669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "AMBER",
        "middle_name": "MICHELE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-15",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.135468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.