NPIMap

Individual provider Active NPI

Christopher L Gleason, M.D.

  • Family Medicine Physician
  • Springfield, IL
National Provider Identifier
1649269887
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036088030 Issued in IL
Practice address
520 N 4TH St
Springfield, IL 62702-5238
Phone
(217) 757-8100
Fax
(217) 757-8161
NPI assigned
Oct 20, 2005
Last updated
Oct 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036088030 IL Primary

Addresses

Primary practice location

520 N 4TH St
Springfield, IL 62702-5238

Mailing address

PO Box 19670
Springfield, IL 62794-9670
Phone (217) 757-8100

Other identifiers 1

IdentifierTypeStateIssuer
036088030MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address christophergleason@siusm.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100604000782 IL Practitioner - Family Practice 1456481282 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

520 N 4TH St
Springfield, IL 62702-5238
Phone (217) 545-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036088030ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Jul 1, 1999 Accepting new patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Oct 1, 2012 Accepting new patients
Board of Trustees of Southern Illinois University Family Medicine Current Accepting new patients
Siu Physicians & Surgeons, Inc Family Medicine CurrentSince Jul 1, 1999 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Oct 1, 2012 Accepting new patients
Southern Illinois University Past Accepting new patients

Locations

520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100

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

Interoperability endpoints

  • Direct secure messaging: christophergleason@siusm.allscriptsdirect.net

Organizations & group practices 7

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 1

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": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1649269887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19670",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949670",
            "telephone_number": "217-757-8100",
            "fax_number": "217-757-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N 4TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025238",
            "telephone_number": "217-757-8100",
            "fax_number": "217-757-8161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "CHRISTOPHER",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036088030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088030",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "christophergleason@siusm.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "520 N 4th St",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627025238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.