Individual provider Active NPI

Nada Berry, MD

  • Surgery of the Hand (Plastic Surgery) Physician
  • Springfield, IL
National Provider Identifier
1619198157
Registry record updated Oct 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery of the Hand (Plastic Surgery) PhysicianTaxonomy code 2082S0105X
License
036-128728 Issued in IL
Practice address
747 N Rutledge St
3Rd Floor
Springfield, IL 62702-6700
Phone
(217) 545-8000
Fax
(217) 545-2588
NPI assigned
May 1, 2007
Last updated
Oct 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 036-128728 IL
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X 036-128728 IL Primary

Addresses

Primary practice location

747 N Rutledge St
3Rd Floor
Springfield, IL 62702-6700

Mailing address

PO Box 19653
Springfield, IL 62794-9653
Phone (217) 545-8000

Other identifiers 1

IdentifierTypeStateIssuer
036128728MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nadaberry@siusm.allscriptsdirect.net

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
I20110831000677 IL Practitioner - Plastic and Reconstructive Surgery 7416080411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Indiana University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

751 N Rutledge St
Springfield, IL 62702-4968
Phone (217) 545-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Mastectomy1-10
Melanoma (skin cancer) excision12
Removal of tissue38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-128728ILMDSurgery of the Hand (Plastic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Sep 12, 2011 Accepting new patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Sep 12, 2011 Accepting new patients
Siu Physicians & Surgeons, Inc Past Accepting new patients

Locations

747 N Rutledge St
Fl 3
Springfield, IL 62702
Phone (217) 545-0885

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

Interoperability endpoints

  • Direct secure messaging: nadaberry@siusm.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 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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602979200000",
    "number": "1619198157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19653",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949653",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 N RUTLEDGE ST",
            "address_2": "3RD FLOOR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627026700",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "NADA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2020-10-18",
        "certification_date": "2020-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": "036-128728",
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "IL",
            "license": "036-128728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036128728",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nadaberry@siusm.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "747 N Rutledge St",
            "address_2": "3RD FLOOR",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627026700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.