Individual provider Active NPI

Ahmed Tag Eldin Sokrab, MD

  • Internal Medicine Physician
  • Springfield, IL
National Provider Identifier
1730594094
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-143869 Issued in IL
Practice address
751 N Rutledge St Ste 1100
Springfield, IL 62702
Phone
(217) 545-8000
Fax
(217) 545-4735
NPI assigned
Jun 25, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-143869 IL Primary

Addresses

Primary practice location

751 N Rutledge St Ste 1100
Springfield, IL 62702

Mailing address

PO Box 19636
Springfield, IL 62794-9636
Phone (217) 545-8000

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180530001685 IL Practitioner - Hospitalist 8729206792 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

751 N Rutledge St
Springfield, IL 62702-4968
Phone (217) 545-8000

Hospital & facility affiliations

  • Memorial Medical Center Hospital, Springfield, IL, CCN 140148
  • Decatur Memorial Hospital Hospital, Decatur, IL, CCN 140135
  • Jacksonville Memorial Hospital Hospital, Jacksonville, IL, CCN 141352
  • Taylorville Memorial Hospital Hospital, Taylorville, IL, CCN 141339
  • St Francis Hospital Hospital, Litchfield, IL, CCN 141350

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 Medicine

State licenses

LicenseStateTypeSpecialty
036-143869ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Oct 8, 2018 Accepting new patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Oct 1, 2024 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Oct 1, 2024 Accepting new patients
Siu Physicians & Surgeons, Inc Internal Medicine CurrentSince Oct 8, 2018 Accepting new patients

Locations

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

751 N Rutledge St
Ste 1100
Springfield, IL 62702
Phone (217) 545-0182

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

701 N 1st St
Springfield, IL 62781
Phone (217) 788-3100

Interoperability endpoints

  • Direct secure messaging: ahmedsokrab@siusm.allscriptsdirect.net

Organizations & group practices 5

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 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": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1730594094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19636",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949636",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-4735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 N RUTLEDGE ST STE 1100",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62702",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-4735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOKRAB",
        "first_name": "AHMED",
        "middle_name": "TAG ELDIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-25",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-143869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.