Individual provider Active NPI

Theresa M Durbin, PA-C

  • Physician Assistant
  • Springfield, IL
National Provider Identifier
1639120967
Registry record updated May 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085001121 Issued in IL
Practice address
900 N 1St St
Springfield, IL 62702-3749
Phone
(217) 528-7541
Fax
(217) 522-2448
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085001121 IL Primary

Addresses

Primary practice location

900 N 1St St
Springfield, IL 62702-3749

Mailing address

1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address theresadurbin@sfc.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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080627000398 IL Practitioner - Physician Assistant 5799857207 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Springfield Clinic, LLPGroup PAC ID 0547166076, shared by 23 NPIs, 678 clinicians

Practice addresses (Care Compare)

100 Stahlhut Dr
Lincoln, IL 62656-5059
Phone (217) 735-9555

1000 W Morton Ave
Jacksonville, IL 62650-3152
Phone (217) 243-6520

1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541

1200 E Tremont St
Hillsboro, IL 62049-1912
Phone (217) 532-4126

1204 E Tremont St
Hillsboro, IL 62049-1912
Phone (217) 532-6266

1215 Franciscan Dr 2ND FLR
Litchfield, IL 62056-1778
Phone (217) 324-8420

1250 E Tremont St
Hillsboro, IL 62049-1912
Phone (217) 532-6911

1280 E Tremont St
Hillsboro, IL 62049-1912
Phone (217) 532-2320

206 N Pearl St
Teutopolis, IL 62467-1134
Phone (217) 528-7541

20613 N Broad St
Carlinville, IL 62626-3720
Phone (217) 854-5099

2200 Wabash Ave
Springfield, IL 62704-5352
Phone (217) 787-0727

250 W Kenwood Ave
Decatur, IL 62526-4371
Phone (217) 528-7541

300 N Broad St
Carlinville, IL 62626-1304
Phone (217) 528-7541

350 W Carpenter St
Springfield, IL 62702-4902
Phone (217) 525-0210

400 Saint Johns Dr
Sherman, IL 62684-9779
Phone (217) 525-4150

600 N Main St
Taylorville, IL 62568-1668
Phone (217) 824-8191

775 Engineering Ave
Springfield, IL 62703-5909
Phone (217) 522-4300

800 N 1St St
Springfield, IL 62702-3719
Phone (217) 528-7541

801 W Temple Ave
Effingham, IL 62401-2168
Phone (217) 528-7541

900 N 1St St
Springfield, IL 62702-3749
Phone (217) 528-7541

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as apm
Quality
75.65
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085001121ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Clinic, LLP CurrentSince Jun 2, 2008 Accepting new patients
Springfield Clinic LLP CurrentSince Feb 15, 2010 Accepting new patients
Springfield Clinic, LLP Past Accepting new patients

Locations

300 N Broad St
Carlinville, IL 62626
Phone (217) 544-2020

1215 Franciscan Dr
Litchfield, IL 62056
Phone (217) 324-2191

1025 S 6th St
Springfield, IL 62703

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

4525 Wabash Ave
Springfield, IL 62711

900 N 1st St
Springfield, IL 62702

401 E Carpenter St
Springfield, IL 62702
Phone (217) 527-3700

600 N Main St
Taylorville, IL 62568
Phone (217) 287-8855

Interoperability endpoints

  • Direct secure messaging: theresa.durbin.1@28977.direct.athenahealth.com

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.

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1639120967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023749",
            "telephone_number": "217-528-7541",
            "fax_number": "217-522-2448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURBIN",
        "first_name": "THERESA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "theresadurbin@sfc.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "900 N 1st St",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627023749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.