NPIMap

Individual provider Active NPI

Chaitanya K Mamillapalli, M.D, MRCP

  • Endocrinology, Diabetes & Metabolism Physician
  • Springfield, IL
National Provider Identifier
1710137930
Registry record updated May 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036-125425 Issued in IL
Practice address
350 W Carpenter St
Springfield, IL 62702-4902
Phone
(217) 528-7541
NPI assigned
Sep 24, 2008
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036-125425 IL Primary

Addresses

Primary practice location

350 W Carpenter St
Springfield, IL 62702-4902

Mailing address

PO Box 19248
Springfield, IL 62794-9248
Phone (217) 528-7541

Other identifiers 1

IdentifierTypeStateIssuer
036125425MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chaitanyamamillapalli@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
I20121203000588 IL Practitioner - EndocrinologyPractitioner - Internal Medicine 8022260728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians

Practice addresses (Care Compare)

350 W Carpenter St
Springfield, IL 62702-4902
Phone (217) 525-0210

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
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Clinic, LLP CurrentSince Mar 1, 2016 Accepting new patients
Springfield Clinic, LLP Past Accepting new patients

Locations

350 W Carpenter St
Springfield, IL 62702
Phone (217) 525-0210

401 E Carpenter St
Springfield, IL 62702
Phone (217) 527-3700

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

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

Interoperability endpoints

  • Direct secure messaging: chaitanya.mamillapalli.1@28977.direct.athenahealth.com
  • Direct secure messaging: chaitanyamamillapalli@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 Oct 1, 2020
Springfield Clinic Nokomis Rural HealthNokomis, IL, CCN 783814 Rural health clinic Limited Partnership Interest Oct 1, 2020
Springfield Clinic Raymond Rural HealthRaymond, IL, CCN 783829 Rural health clinic Limited Partnership Interest Oct 1, 2020
Springfield Clinic Neoga Rural HealthNeoga, IL, CCN 783812 Rural health clinic Limited Partnership Interest Oct 1, 2020
Springfield Clinic, LLPMacomb, IL, CCN 783855 Rural health clinic Limited Partnership Interest Oct 1, 2020

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 2

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 6

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": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1710137930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19248",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949248",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W CARPENTER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024902",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMILLAPALLI",
        "first_name": "CHAITANYA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D, MRCP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-24",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036-125425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036125425",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chaitanyamamillapalli@sfc.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "350 W Carpenter St",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627024902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.