Individual provider Active NPI

Ronald V Hublall, MD

  • Diagnostic Radiology Physician
  • Springfield, IL
National Provider Identifier
1740329242
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036-117104 Issued in IL
Practice address
800 E Carpenter St
Springfield, IL 62769-1625
Phone
(217) 544-6464
NPI assigned
Feb 5, 2007
Last updated
Feb 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD462725 PA
Diagnostic Radiology Physician 2085R0202X 036-117104 IL Primary
Diagnostic Radiology Physician 2085R0202X 2004001951 MO

Addresses

Primary practice location

800 E Carpenter St
Springfield, IL 62769-1625

Mailing address

111 Oakwood Rd
East Peoria, IL 61611-1853
Phone (309) 740-4272

Other practice location 1

1 Guthrie Sq
Sayre, PA 18840-1625
Phone (570) 887-4000

Other practice location 2

29 NW 1st Ln
LaMar, MO 64759-8105
Phone (417) 681-5101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY, IL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20180123001432 PA Practitioner - Diagnostic Radiology 5890776207 Reassigns benefits to 1 organization
I20180425001733 NY Practitioner - Diagnostic Radiology 5890776207 Reassigns benefits to 1 organization
I20190912000788 IL Practitioner - Diagnostic Radiology 5890776207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Illinois Radiological Associates LTDGroup PAC ID 9436061827, 205 clinicians

Practice addresses (Care Compare)

111 Oakwood Rd
East Peoria, IL 61611-1853
Phone (309) 740-4272

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-117104ILMDDiagnostic Radiology Physician
2004001951MOMDDiagnostic Radiology Physician
MD462725PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. CurrentSince Mar 13, 2018 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Dec 1, 2017 Accepting new patients
Central Illinois Radiological Associates, LTD. Diagnostic Radiology CurrentSince Aug 26, 2019 Accepting new patients
Guthrie Medical Group, P.C, Diagnostic Radiology CurrentSince Dec 1, 2017 Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients
Maryville Imaging, LLC CurrentSince Dec 23, 2025 Accepting new patients
Maryville Imaging, LLC CurrentSince Dec 23, 2025 Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients
Encompass Medical Group, PA Diagnostic Radiology Past Accepting new patients
Medical Plaza Imaging Associates, LLC Diagnostic Radiology Past Accepting new patients
Western Missouri Radiological Group Inc Diagnostic Radiology Past Accepting new patients
Hot Springs MRI Center Past Accepting new patients
Northland Imaging, LLC Past Accepting new patients
Cira Michigan PC Diagnostic Radiology Past Accepting new patients

Locations

5200 Reliable Pkwy
Chicago, IL 60686
Phone (309) 671-8748

5900 Bond Ave
East Saint Louis, IL 62207
Phone (618) 332-3060

111 Oakwood Rd
Peoria, IL 61611

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

530neglen Oak Ave
Peoria, IL 61636
Phone (309) 685-1054

800 E Carpenter St
Springfield, IL 62769
Phone (217) 525-5643

1 Guthrie Dr
Corning, NY 14830
Phone (607) 937-7130

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

132 Colonial Dr
Towanda, PA 18848
Phone (570) 265-6165

Organizations & group practices 14

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.

View all 14

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1740329242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 OAKWOOD RD",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616111853",
            "telephone_number": "309-740-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CARPENTER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627691625",
            "telephone_number": "217-544-6464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Guthrie Sq",
            "address_purpose": "LOCATION",
            "city": "Sayre",
            "state": "PA",
            "postal_code": "188401625",
            "country_code": "US",
            "telephone_number": "570-887-4000",
            "fax_number": "570-887-5775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "29 NW 1st Ln",
            "address_purpose": "LOCATION",
            "city": "LaMar",
            "state": "MO",
            "postal_code": "647598105",
            "country_code": "US",
            "telephone_number": "417-681-5101",
            "fax_number": "417-681-5510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUBLALL",
        "first_name": "RONALD",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD462725",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036-117104",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2004001951",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.