Individual provider Active NPI

Jason R Michaels, MD

  • Pain Medicine (Anesthesiology) Physician
  • Springfield, IL
National Provider Identifier
1679988521
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
036145873 Issued in IL
Practice address
701 N 1St St
Springfield, IL 62702-3757
Phone
(217) 545-0182
Fax
(217) 545-4735
NPI assigned
Jun 29, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036-145873 IL
Pain Medicine (Anesthesiology) Physician 207LP2900X 036145873 IL Primary

Addresses

Primary practice location

701 N 1St St
Springfield, IL 62702-3757

Mailing address

611 W. Park St
Fapc
Urbana, IL 61801

Other practice location 1

1111 Trinity Ln Ste 111
Bloomington, IL 61704-8112
Phone (309) 663-6461

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
I20190625002563 IL Practitioner - Pain Management 4688891625 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Southern Illinois University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle West Physician Group IncGroup PAC ID 8921420308, 282 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

2204 Eastland Dr
Bloomington, IL 61704-3567
Phone (309) 663-0222

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-145873ILMDAnesthesiology Physician
036145873ILMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carle West Physician Group Inc CurrentSince Aug 30, 2021 Accepting new patients
Carle Health Care Incorporated Anesthesiology CurrentSince Oct 4, 2025 Accepting new patients
Carle Eureka Hospital Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1111 Trinity Ln
Ste 111
Bloomington, IL 61704
Phone (309) 663-6461

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

3310 Fields South Dr
Champaign, IL 61822
Phone (217) 417-2352

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: jmichaelsmd322997@carlehiedirect.net

Organizations & group practices 4

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 3

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": "1404000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1679988521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801"
        },
        {
            "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": "627023757",
            "telephone_number": "217-545-0182",
            "fax_number": "217-545-4735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 Trinity Ln Ste 111",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IL",
            "postal_code": "617048112",
            "country_code": "US",
            "telephone_number": "309-663-6461",
            "fax_number": "309-663-5711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHAELS",
        "first_name": "JASON",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-29",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036-145873",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036145873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.