Individual provider Active NPI

Cassandra L Eilers, LCSW

  • Clinical Social Worker
  • Taylorville, IL
National Provider Identifier
1679226930
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.025977 Issued in IL
Practice address
303 E Bidwell St
Taylorville, IL 62568-1363
Phone
(217) 824-3566
Fax
(217) 824-1344
NPI assigned
Jan 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.025977 IL Primary

Addresses

Primary practice location

303 E Bidwell St
Taylorville, IL 62568-1363

Mailing address

201 E Madison St Ste 328
Springfield, IL 62702-5131
Phone (217) 545-8000

Other identifiers 2

IdentifierTypeStateIssuer
149025977OtherILLCSW
150105849OtherILLSW

Other names 1

  • Cassandra L Smart Former 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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231102002103 IL Practitioner - Clinical Social Worker 3173979747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Board of Trustees of Southern Illinois UniversityGroup PAC ID 4486667888, 139 clinicians

Practice addresses (Care Compare)

303 E Bidwell St
Taylorville, IL 62568-1363
Phone (217) 545-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.025977ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University CurrentSince Nov 27, 2023 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Nov 27, 2023 Accepting new patients

Locations

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

303 E Bidwell St
Taylorville, IL 62568
Phone (217) 824-1134

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1643241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1679226930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E MADISON ST STE 328",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025131",
            "telephone_number": "217-545-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E BIDWELL ST",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625681363",
            "telephone_number": "217-824-3566",
            "fax_number": "217-824-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EILERS",
        "first_name": "CASSANDRA",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-27",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.025977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "149025977",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LSW",
            "identifier": "150105849",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSANDRA",
            "last_name": "SMART",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Taylorville, IL

Sources for this page

Verify at the official NPI Registry.