Individual provider Active NPI

Todd Diebold, D.O.

  • Obstetrics & Gynecology Physician
  • Decatur, IL
National Provider Identifier
1689081861
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036148191 Issued in IL
Practice address
2 Memorial Dr FL 1
Decatur, IL 62526-3950
Phone
(217) 545-8000
NPI assigned
Jul 19, 2014
Last updated
Nov 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036148191 IL Primary

Addresses

Primary practice location

2 Memorial Dr FL 1
Decatur, IL 62526-3950

Mailing address

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

Other practice location 1

320 E Central Ave
Decatur, IL 62521-4665
Phone (217) 545-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address todddiebold@sfc.allscriptsdirect.net

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
I20190628000270 IL Practitioner - Obstetrics/Gynecology 3274759956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Kansas City University of Physicians and Surgeons, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians
Community Health Improvement CenterGroup PAC ID 4385625342, shared by 3 NPIs, 13 clinicians

Practice addresses (Care Compare)

320 E Central Ave
Decatur, IL 62521-4665
Phone (217) 545-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as apm
Quality
75.65
Promoting interoperability
100
Improvement activities
40

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
036148191ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Apr 18, 2024 Accepting new patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Siu Physicians & Surgeons, Inc Family Medicine CurrentSince Apr 18, 2024 Accepting new patients

Locations

2 Memorial Dr
Fl 1
Decatur, IL 62526
Phone (217) 872-2930

320 E Central Ave
Decatur, IL 62521
Phone (217) 877-4694

201 E Madison St
Ste 328
Springfield, IL 62702

415 N 9th St
Springfield, IL 62702
Phone (217) 545-5117

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

Interoperability endpoints

  • Direct secure messaging: todd.diebold.p31@direct.fhn-fqhc.nextgenshare.com
  • Direct secure messaging: todddiebold@siusm.allscriptsdirect.net

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 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": "1405728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1689081861",
    "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": "844-470-2486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEMORIAL DR FL 1",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263950",
            "telephone_number": "217-545-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 E Central Ave",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625214665",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIEBOLD",
        "first_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-19",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036148191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "todddiebold@sfc.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "900 N 1st St",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627023749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.