Individual provider Active NPI

Brockton Tonazzi, MD

  • Diagnostic Radiology Physician
  • Springfield, IL
National Provider Identifier
1649062597
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
125.085709 Issued in IL
Practice address
800 E Carpenter Street Box 43
Springfield, IL 62769-0043
Phone
(217) 814-5178
Fax
(217) 757-6458
NPI assigned
May 19, 2025
Last updated
Jun 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 125.085709 IL Primary

Addresses

Primary practice location

800 E Carpenter Street Box 43
Springfield, IL 62769-0043

Mailing address

PO Box 19636
Springfield, IL 62794-9636
Phone (217) 814-5178

Other names 1

  • Brock Tonazzi Other name

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
I20250708002429 IL Order and Referring Only - Diagnostic RadiologyPractitioner - Internal MedicinePractitioner - Diagnostic Radiology 2163936600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.085709ILMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1747612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1649062597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19636",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949636",
            "telephone_number": "217-814-5178",
            "fax_number": "217-757-6458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CARPENTER STREET BOX 43",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627690043",
            "telephone_number": "217-814-5178",
            "fax_number": "217-757-6458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONAZZI",
        "first_name": "BROCKTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-19",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "125.085709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROCK",
            "last_name": "TONAZZI",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.