Individual provider Active NPI

Nicole L Rottinghaus, CRNA

  • Certified Registered Nurse Anesthetist
  • Springfield, IL
National Provider Identifier
1770544439
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Practice address
701 N 1St St
Springfield, IL 62781-0001
Phone
(217) 788-3754
Fax
(217) 788-7071
NPI assigned
Mar 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X IL Primary

Addresses

Primary practice location

701 N 1St St
Springfield, IL 62781-0001

Mailing address

701 N 1St St
Springfield, IL 62781-0001
Phone (217) 788-3754

Other identifiers 1

IdentifierTypeStateIssuer
046804OtherCCNA CERTIFICATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040928000058 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395714331 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Medical CenterGroup PAC ID 7315835949, 131 clinicians

Practice addresses (Care Compare)

701 N 1St St
Springfield, IL 62781-0001
Phone (217) 788-3755

Hospital & facility affiliations

  • Memorial Medical Center Hospital, Springfield, IL, CCN 140148

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as apm
Quality
75.65
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Clinic, LLP CurrentSince Feb 15, 2006 Accepting new patients
Decatur Memorial Hospital Past Accepting new patients
Sangamon Associated Anesthesiologists, S.C. Nurse Anesthetist, Certified Registered Past Accepting new patients
Decatur Memorial Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

300 N Broad St
Carlinville, IL 62626
Phone (217) 544-2020

1001 Morgan St
Carlinville, IL 62626
Phone (217) 854-3141

2300 N Edward St
Ste 1910
Decatur, IL 62526
Phone (217) 876-2645

800 E Carpenter St
Rm 2K
Springfield, IL 62769
Phone (217) 525-5643

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

1025 S 7th St
Springfield, IL 62703
Phone (217) 525-7541

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

800 E Carpenter St
Rm 2334
Springfield, IL 62769
Phone (217) 525-5643

1025 S 6th St
Springfield, IL 62703

800 E Carpenter St
Rm 2K64
Springfield, IL 62702

Interoperability endpoints

  • Direct secure messaging: nicole.rottinghaus.1@28977.direct.athenahealth.com

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 1

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197504000000",
    "number": "1770544439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627810001",
            "telephone_number": "217-788-3754",
            "fax_number": "217-788-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627810001",
            "telephone_number": "217-788-3754",
            "fax_number": "217-788-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTTINGHAUS",
        "first_name": "NICOLE",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2007-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCNA CERTIFICATION",
            "identifier": "046804",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.