Individual provider Active NPI

Matthew Cleveland, MD

  • Diagnostic Radiology Physician
  • Springfield, IL
National Provider Identifier
1780243766
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
125.074560 Issued in IL
Practice address
701 N 1St St
Springfield, IL 62702-3757
Phone
(217) 545-8000
Fax
(217) 545-4735
NPI assigned
Jun 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125074560 IL
Diagnostic Radiology Physician 2085R0202X 125.074560 IL Primary

Addresses

Primary practice location

701 N 1St St
Springfield, IL 62702-3757

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251002001802 IL Practitioner - Diagnostic Radiology 3476887951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Southern Illinois University School of Medicine, 2019
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

  • St Johns Hospital Hospital, Springfield, IL, CCN 140053
  • HSHS St Elizabeth'S Hospital Hospital, O Fallon, IL, CCN 140187
  • St Anthonys Memorial Hospital Hospital, Effingham, IL, CCN 140032
  • St Marys Hospital Hospital, Decatur, IL, CCN 140166
  • St Josephs Hospital Hospital, Breese, IL, CCN 140145

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.074560ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Illinois Radiological Associates, LTD. Diagnostic Radiology CurrentSince Aug 1, 2025 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

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

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

111 Oakwood Rd
Peoria, IL 61611
Phone (586) 412-4144

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1780243766",
    "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": "701 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023757",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-4735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVELAND",
        "first_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-12",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125074560",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "125.074560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.