Maoxiim Tellez, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036117662 Issued in IL

Practice address

1 Centre Dr
Petersburg, IL 62675-9467

Phone

(217) 632-7761

Fax

(217) 632-0312

NPI assigned

Mar 8, 2007

Last updated

Nov 3, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Menard Medical Center, LLCGroup PAC ID 2769547090, 9 clinicians

Memorial Physician ServicesGroup PAC ID 9032005681, 161 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enhabit Home Health Home health agency, Springfield, IL, CCN 147708
• Hospice Care of Illinois Hospice, Springfield, IL, CCN 141540
• Memorial Medical Center Hospital, Springfield, IL, CCN 140148
• Sunny Acres Nursing Home Nursing home, Petersburg, IL, CCN 146068
• Regency Care Nursing home, Springfield, IL, CCN 146139

Merit-based Incentive Payment System (MIPS)

Final score

79.44 of 100Reported as group

Quality

71.79

Promoting interoperability

77

Improvement activities

40

Cost

75.71

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maoxiimtellez@memorial.allscriptsdirect.net
• Direct secure messaging: maoxiimtellez@sfc.allscriptsdirect.net

All facility ownership & control disclosures 2

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

Owned or controlled facilities with NPI records 2

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

• Rutledge-Regency Operations, LLC

  dba Regency Care

  • Skilled Nursing Facility
  • Springfield, IL
  • NPI 1053557009

  Adp of the SNF, Corporate Director, Operational/Managerial Control

  CMS ownership
• Sunny Acres

  dba Sunny Acres Nursing Home

  • Skilled Nursing Facility
  • Petersburg, IL
  • NPI 1497856785

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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.

• Memorial Physician Services

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1174877930
  Medicare reassignment Care Compare group
• Family Medical Center of Chatham, LLC

  • Family Medicine Physician
  • Chatham, IL
  • NPI 1992956528
  NPD
• Memorial Health Partners

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1376034744
  NPD
• Memorial Physician Services

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1417922964

  Family Medicine

  NPD
• Springfield Clinic LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1215974415
  NPD
• Memorial Physician Services

  • Rural Health Clinic/Center
  • Jacksonville, IL
  • NPI 1104179415
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Eh Home Health of the Midwest, LLC

  dba Enhabit Home Health

  • Home Health Agency
  • Springfield, IL
  • NPI 1477006161
  Care Compare affiliation
• Memorial Home Services

  • Community Based Hospice Care Agency
  • Springfield, IL
  • NPI 1003935560
  Care Compare affiliation
• Memorial Medical Center

  • General Acute Care Hospital
  • Springfield, IL
  • NPI 1255317590
  Care Compare affiliation
• Rutledge-Regency Operations, LLC

  dba Regency Care

  • Skilled Nursing Facility
  • Springfield, IL
  • NPI 1053557009

  Nursing home

  Care Compare affiliation
• Sunny Acres

  dba Sunny Acres Nursing Home

  • Skilled Nursing Facility
  • Petersburg, IL
  • NPI 1497856785

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1740311349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3428",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627083428",
            "telephone_number": "800-577-5368",
            "fax_number": "217-757-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CENTRE DR",
            "city": "PETERSBURG",
            "state": "IL",
            "postal_code": "626759467",
            "telephone_number": "217-632-7761",
            "fax_number": "217-632-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLEZ",
        "first_name": "MAOXIIM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036117662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kay Sill, NP
• Ashleigh Renee Smith
• Student
• Sunny Acres (Sunny Acres Nursing Home)
• Sunny Acres (Sunny Acres Nursing Home)
• Linda K Thornberry, LCSW
• Abbey Lynn Venturini, LCSW
• Heather Walker
• Richard Eugene Wolf Jr.

• Family Medicine Physician in Petersburg, IL
• Providers in Petersburg, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.