Individual provider Active NPI

David M Ayoub, MD

  • Diagnostic Radiology Physician
  • Springfield, IL
National Provider Identifier
1861448037
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036075460 Issued in IL
Practice address
3050 Montvale Dr Ste a
Springfield, IL 62704-6924
Phone
(217) 726-8096
NPI assigned
May 26, 2006
Last updated
Aug 3, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036075460 IL Primary

Addresses

Primary practice location

3050 Montvale Dr Ste a
Springfield, IL 62704-6924

Mailing address

2040 W Iles Ave
Suite C
Springfield, IL 62704-4183
Phone (217) 789-7743

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
I20041118000207 IL Practitioner - Diagnostic Radiology 0749257681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RemloGroup PAC ID 5193800258, 32 clinicians

Practice addresses (Care Compare)

525 E Grant St
Macomb, IL 61455-3313
Phone (309) 833-4101

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036075460ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Remlo Diagnostic Radiology CurrentSince Oct 1, 2020 Accepting new patients
Crawford Hospital District Family Medicine Current Accepting new patients
Affiliated Radiologists, SC Past Accepting new patients
Memorial Medical Center Past Accepting new patients
Metropolitan Advanced Radiological Services, LTD. Diagnostic Radiology Past Accepting new patients

Locations

525 E Grant St
Macomb, IL 61455
Phone (309) 836-1611

1000 N Allen St
Robinson, IL 62454
Phone (618) 544-3131

Interoperability endpoints

  • Direct secure messaging: dayou@yourcarecommunity.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1861448037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 W ILES AVE",
            "address_2": "SUITE C",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044183",
            "telephone_number": "217-789-7743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 MONTVALE DR STE A",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046924",
            "telephone_number": "217-726-8096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYOUB",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036075460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.