Individual provider Active NPI

Ryan Matthew Majcina, M.D.

  • Pediatric Critical Care Medicine Physician
  • Springfield, IL
National Provider Identifier
1619026135
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
036-135564 Issued in IL
Practice address
415 N 9TH St
Suite 4W16
Springfield, IL 62702-5303
Phone
(217) 545-8000
Fax
(217) 757-6654
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D68804 MD
Pediatric Critical Care Medicine Physician 2080P0203X 036-135564 IL Primary

Addresses

Primary practice location

415 N 9TH St
Suite 4W16
Springfield, IL 62702-5303

Mailing address

PO Box 19676
Springfield, IL 62794-9676
Phone (217) 545-8000

Other identifiers 1

IdentifierTypeStateIssuer
417470400MedicaidMD

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
I20140801001085 IL Practitioner - Pediatric Medicine 7517018500 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D68804MDMDPediatrics Physician
036-135564ILMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Jul 1, 2014 Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Jul 1, 2014 Accepting new patients
Siu Physicians & Surgeons, Inc Pediatrics Past Accepting new patients

Locations

415 N 9th St
Ste 4W16
Springfield, IL 62702
Phone (800) 331-2229

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

415 N 9th St
Springfield, IL 62702
Phone (217) 545-5117

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1619026135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19676",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949676",
            "telephone_number": "217-545-8000",
            "fax_number": "217-757-6654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N 9TH ST",
            "address_2": "SUITE 4W16",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025303",
            "telephone_number": "217-545-8000",
            "fax_number": "217-757-6654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAJCINA",
        "first_name": "RYAN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D68804",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "IL",
            "license": "036-135564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "417470400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.