NPIMap

Individual provider Active NPI

Chandrakiran Jwala, M.D.

  • Hospitalist Physician
  • Springfield, IL
National Provider Identifier
1649529306
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036145172 Issued in IL
Practice address
701 N 1St St
Springfield, IL 62781-5303
Phone
(217) 528-7541
NPI assigned
Sep 9, 2012
Last updated
Jun 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X MD-42687 IA
Hospitalist Physician 208M00000X 036145172 IL Primary

Addresses

Primary practice location

701 N 1St St
Springfield, IL 62781-5303

Mailing address

PO Box 19248
Springfield, IL 62794-9248
Phone (217) 528-7541

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
I20200212000440 IL Practitioner - Hospitalist 9638485766 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trinity Medical Staffing LLCGroup PAC ID 1759712698, 35 clinicians
24 On Physicians PCGroup PAC ID 5698688141, 274 clinicians

Practice addresses (Care Compare)

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946-2718
Phone (618) 253-7671

2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 529-0529

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as group
Quality
77.5
Improvement activities
40
Cost
74.58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-42687IAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
24 On Physicians, PC Hospitalist CurrentSince May 10, 2023 Accepting new patients
Trinity Medical Staffing LLC CurrentSince Jun 1, 2022 Accepting new patients
24 On Physicians, P.C. Hospitalist CurrentSince May 10, 2023 Accepting new patients

Locations

13000 Deerfield Pkwy
Ste 100
Alpharetta, GA 30004

2250 N Illinois Ave
Carbondale, IL 62901
Phone (618) 833-1691

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946
Phone (618) 252-4956

201 S 14th St
Herrin, IL 62948
Phone (618) 942-2171

2 S Hospital Dr
Murphysboro, IL 62966
Phone (618) 684-3156

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

Interoperability endpoints

  • Direct secure messaging: cjwala62949@sih.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1347148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1649529306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19248",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949248",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627815303",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JWALA",
        "first_name": "CHANDRAKIRAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-09",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IA",
            "license": "MD-42687",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036145172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.