Active NPI
Joseph D. Conlon, M.D.
- Pediatric Dermatology Physician
- Springfield, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dermatology Physician
- License
- 036115705
- Practice address
- 3501 Old Jacksonville Rd
Springfield, IL 62711-8358 - Phone
- (217) 528-7541
- NPI assigned
- Jun 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 036115705 | IL | |
| Pediatric Dermatology Physician | 207NP0225X | 036115705 | IL | Primary |
Addresses
Primary practice location
3501 Old Jacksonville Rd
Springfield, IL 62711-8358
Mailing address
1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036115705 | Medicaid | IL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | josephconlon@sfc.allscriptsdirect.net |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060627000115 | IL | Practitioner - Dermatology | 8224040787 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 88.83 of 100
- Quality
- 75.65
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036115705 | IL | MD | Pediatric Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Siu Physicians & Surgeons, Inc | Current | Accepting new patients | |
| Siu Physicians & Surgeons, Inc | Dermatology | Current | Accepting new patients |
| Board of Trustees of Southern Illinois University | Current | Accepting new patients | |
| Springfield Clinic, LLP | Current | Accepting new patients |
Locations
300 N Broad St
Carlinville, IL 62626
Phone (217) 544-2020
1025 S 6th St
Springfield, IL 62703
751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182
775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300
3501 Old Jacksonville Rd
Springfield, IL 62711
Phone (217) 960-8193
2200 Wabash Ave
Springfield, IL 62704
Interoperability endpoints
- joseph.conlon.1@28977.direct.athenahealth.com
- josephconlon@siusm.allscriptsdirect.net
Ownership & related parties
All facility ownership & control disclosures 5
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Springfield Clinic Lincoln Rural Health | Rural health clinic | Limited Partnership Interest | Jan 1, 2009 |
| Springfield Clinic Nokomis Rural Health | Rural health clinic | Limited Partnership Interest | Jan 1, 2009 |
| Springfield Clinic Raymond Rural Health | Rural health clinic | Limited Partnership Interest | Jan 1, 2009 |
| Springfield Clinic Neoga Rural Health | Rural health clinic | Limited Partnership Interest | Jan 1, 2009 |
| Springfield Clinic, LLP | Rural health clinic | Limited Partnership Interest | Jan 1, 2009 |
Owned or controlled facilities with NPI records 5
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Rural Health Clinic/Center
- Raymond, IL
- NPI 1013255942
Limited Partnership Interest
-
- Rural Health Clinic/Center
- Macomb, IL
- NPI 1730831157
Limited Partnership Interest
-
- Rural Health Clinic/Center
- Neoga, IL
- NPI 1972790889
Limited Partnership Interest
-
- Rural Health Clinic/Center
- Lincoln, IL
- NPI 1518143452
Limited Partnership Interest
-
- Rural Health Clinic/Center
- Nokomis, IL
- NPI 1922285600
Limited Partnership Interest
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.
-
- Endocrinology, Diabetes & Metabolism Physician
- Springfield, IL
- NPI 1558385989
Dermatology, IL
-
- Rural Health Clinic/Center
- Carbondale, IL
- NPI 1215978127
-
- Durable Medical Equipment & Medical Supplies
- Springfield, IL
- NPI 1164055976
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728259200000",
"number": "1831131697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 S 6TH ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627032403",
"telephone_number": "217-528-7541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3501 OLD JACKSONVILLE RD",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627118358",
"telephone_number": "217-528-7541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONLON",
"first_name": "JOSEPH",
"middle_name": "D.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2024-10-07",
"certification_date": "2024-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "IL",
"license": "036115705",
"primary": false
},
{
"code": "207NP0225X",
"taxonomy_group": "",
"desc": "Dermatology, Pediatric Dermatology",
"state": "IL",
"license": "036115705",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036115705",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "josephconlon@sfc.allscriptsdirect.net",
"affiliation": "N",
"address_1": "2200 Wabash Ave",
"city": "Springfield",
"state": "IL",
"country_code": "US",
"postal_code": "627045352",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- 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.