Individual provider Active NPI

Ashima Datey Chakrabarty, MD

  • Psychiatry Physician
  • Springfield, IL
National Provider Identifier
1669992343
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036.153654 Issued in IL
Practice address
319 E Madison St FL 3
Springfield, IL 62701-1035
Phone
(217) 545-8000
NPI assigned
Jun 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.153654 IL
Psychiatry Physician 2084P0800X 036.153654 IL Primary

Addresses

Primary practice location

319 E Madison St FL 3
Springfield, IL 62701-1035

Mailing address

PO Box 19639
Springfield, IL 62794-9639
Phone (217) 545-8000

Other practice location 1

701 N 1st St
Springfield, IL 62702-3757
Phone (217) 545-8000

Other practice location 2

1600 W Walnut St
Jacksonville, IL 62650-1136
Phone (217) 245-7275

Other practice location 3

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

Other practice location 4

319 E Madison St Ste 1F
Springfield, IL 62701-3118
Phone (217) 545-8000

Other practice location 5

710 N 8th St
Springfield, IL 62702-6324
Phone (217) 588-7717

Other practice location 6

102 W Kenwood Ave Ste 100
Decatur, IL 62526-4379
Phone (217) 872-3800

Other names 1

  • Ashima Sanjay Datey Professional 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
I20220825000255 IL Practitioner - Psychiatry 5698046688 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

319 E Madison St
FL 3
Springfield, IL 62701-1035
Phone (217) 545-8000

710 N 8TH St
Springfield, IL 62702-6324
Phone (217) 588-7717

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Sep 26, 2022 Accepting new patients
Siu Physicians & Surgeons, Inc Internal Medicine CurrentSince Sep 26, 2022 Accepting new patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Sep 26, 2022 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Sep 26, 2022 Accepting new patients

Locations

102 W Kenwood Ave
Ste 100
Decatur, IL 62526
Phone (217) 872-3800

1600 W Walnut St
South Jacksonville, IL 62650
Phone (217) 245-7275

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

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

319 E Madison St
Fl 3
Springfield, IL 62701
Phone (217) 545-7627

201 E Madison St
Ste 328
Springfield, IL 62702

701 N 1st St
Springfield, IL 62702
Phone (217) 545-0182

319 E Madison St
Ste 1F
Springfield, IL 62701
Phone (217) 788-3948

Interoperability endpoints

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

Organizations & group practices 5

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 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": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1669992343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 E MADISON ST FL 3",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011035",
            "telephone_number": "217-545-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 N 1st St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627023757",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 W Walnut St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "IL",
            "postal_code": "626501136",
            "country_code": "US",
            "telephone_number": "217-245-7275",
            "fax_number": "217-245-7427",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "520 N 4th St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627025238",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "fax_number": "217-757-8161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "319 E Madison St Ste 1F",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627013118",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "fax_number": "217-757-8161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "710 N 8th St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627026324",
            "country_code": "US",
            "telephone_number": "217-588-7717",
            "fax_number": "217-525-1503",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 W Kenwood Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625264379",
            "country_code": "US",
            "telephone_number": "217-872-3800",
            "fax_number": "217-872-0849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DATEY CHAKRABARTY",
        "first_name": "ASHIMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.153654",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036.153654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHIMA",
            "last_name": "DATEY",
            "middle_name": "SANJAY",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.