Individual provider Active NPI

Robert Matthew Tennill, M.D.

  • Emergency Medicine Physician
  • Springfield, IL
National Provider Identifier
1801215231
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036.145116 Issued in IL
Practice address
701 N 1St St
Springfield, IL 62781
Phone
(217) 788-3156
Fax
(217) 788-6459
NPI assigned
Apr 14, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036.145116 IL Primary

Addresses

Primary practice location

701 N 1St St
Springfield, IL 62781

Mailing address

701 N 1St St
Springfield, IL 62781-0001
Phone (217) 788-3156

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
I20180615000003 IL Practitioner - Emergency Medicine 2062710734 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Southern Illinois University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Emergency Department Specialists LTDGroup PAC ID 5193627727, 62 clinicians

Practice addresses (Care Compare)

701 N 1St St
Springfield, IL 62781-3757
Phone (217) 788-3156

Hospital & facility affiliations

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.145116ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Passavant Memorial Area Hospital Association CurrentSince Nov 1, 2023 Accepting new patients
Passavant Memorial Area Hospital Association CurrentSince Jan 7, 2026 Accepting new patients
Midwest Emergency Department Specialists LTD Emergency Medicine CurrentSince Jul 1, 2018 Accepting new patients
Passavant Memorial Area Hospital Association CurrentSince Nov 1, 2023 Accepting new patients

Locations

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

1600 W Walnut St
South Jacksonville, IL 62650
Phone (217) 245-7275

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

Organizations & group practices 4

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": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1801215231",
    "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": "217-788-3156",
            "fax_number": "217-788-6459"
        },
        {
            "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": "62781",
            "telephone_number": "217-788-3156",
            "fax_number": "217-788-6459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNILL",
        "first_name": "ROBERT",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-14",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.145116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.