NPIMap

Individual provider Active NPI

Paul Evan Pacheco, M.D.

  • Colon & Rectal Surgery Physician
  • Springfield, IL
National Provider Identifier
1689872905
Registry record updated May 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
036127621 Issued in IL
Practice address
900 N 1St St
Springfield, IL 62702-3749
Phone
(217) 528-7541
NPI assigned
Jul 8, 2007
Last updated
May 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036127621 IL
Colon & Rectal Surgery Physician 208C00000X 036127621 IL Primary

Addresses

Primary practice location

900 N 1St St
Springfield, IL 62702-3749

Mailing address

1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address paulpacheco@sfc.allscriptsdirect.net

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
I20120810000403 IL Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 0345496162 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Springfield Clinic, LLPGroup PAC ID 0547166076, shared by 23 NPIs, 678 clinicians

Practice addresses (Care Compare)

900 N 1St St
Springfield, IL 62702-3749
Phone (217) 528-7541

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy99
Upper gastrointestinal (GI) endoscopy for acid reflux12
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036127621ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Clinic LLP CurrentSince Jun 26, 2021 Accepting new patients
Springfield Clinic, LLP CurrentSince Aug 20, 2012 Accepting new patients
Springfield Clinic, LLP Past Accepting new patients

Locations

1250 E Tremont St
Hillsboro, IL 62049
Phone (217) 532-6911

1215 Franciscan Dr
Litchfield, IL 62056
Phone (217) 324-2191

1025 S 6th St
Springfield, IL 62703

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

900 N 1st St
Springfield, IL 62702

600 N Main St
Taylorville, IL 62568
Phone (217) 287-8855

Interoperability endpoints

  • Direct secure messaging: paul.pacheco.1@28977.direct.athenahealth.com
  • Direct secure messaging: paulpacheco@sfc.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Springfield Clinic Lincoln Rural HealthLincoln, IL, CCN 143925 Rural health clinic Limited Partnership Interest Jan 1, 2015
Springfield Clinic Nokomis Rural HealthNokomis, IL, CCN 783814 Rural health clinic Limited Partnership Interest Jan 1, 2015
Springfield Clinic Raymond Rural HealthRaymond, IL, CCN 783829 Rural health clinic Limited Partnership Interest Jan 1, 2015
Springfield Clinic Neoga Rural HealthNeoga, IL, CCN 783812 Rural health clinic Limited Partnership Interest Jan 1, 2015
Springfield Clinic, LLPMacomb, IL, CCN 783855 Rural health clinic Limited Partnership Interest Jan 1, 2015

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 5

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": "1183852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1689872905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023749",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "PAUL",
        "middle_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-08",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036127621",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "IL",
            "license": "036127621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "paulpacheco@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 Springfield, IL

Sources for this page

Verify at the official NPI Registry.