NPIMap

Individual provider Active NPI

Benjamin Robert Coleman, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Eureka, IL
National Provider Identifier
1811036312
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
036118784 Issued in IL
Practice address
101 S Major St
Eureka, IL 61530-1246
Phone
(309) 304-2115
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036118784 IL Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 01061533A IN

Addresses

Primary practice location

101 S Major St
Eureka, IL 61530-1246

Mailing address

611 W Park St
Urbana, IL 61801-2529

Other practice location 1

1800 E Lake Shore Dr
Department of Pathology
Decatur, IL 62521-3810
Phone (217) 464-2060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070816000736 IL Practitioner - Pathology 7911099270 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
K M B S CGroup PAC ID 1951365303, 3 clinicians

Practice addresses (Care Compare)

1304 Franklin Ave
Normal, IL 61761-3558
Phone (309) 268-5128

422 W White St
Clinton, IL 61727-2272
Phone (217) 935-9571

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01061533AINMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City of Clinton Current Accepting new patients
K M B S C Anatomic Pathology & Clinical Pathology CurrentSince Jul 23, 2007 Accepting new patients

Locations

422 W White St
Clinton, IL 61727
Phone (217) 935-9570

1800 E Lake Shore Dr
Decatur, IL 62521
Phone (217) 464-2729

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 24

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

View all 24

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": "1789344000000",
    "number": "1811036312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S MAJOR ST",
            "city": "EUREKA",
            "state": "IL",
            "postal_code": "615301246",
            "telephone_number": "309-304-2115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 E Lake Shore Dr",
            "address_2": "Department of Pathology",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625213810",
            "country_code": "US",
            "telephone_number": "217-464-2060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "BENJAMIN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036118784",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01061533A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, IL

Sources for this page

Verify at the official NPI Registry.