Active NPI
Mohammad WS Baidoun, MD
- Pediatric Cardiology Physician
- Springfield, IL
National Provider Identifier
1871154971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Cardiology Physician
- License
- 036.173832
- Practice address
- 400 N 9TH St FL 2
Springfield, IL 62702-5310 - Phone
- (217) 545-8000
- Fax
- (217) 545-2303
- NPI assigned
- Jun 28, 2019
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 4351045426 | MI | |
| Pediatric Cardiology Physician | 2080P0202X | 036.173832 | IL | Primary |
Addresses
Primary practice location
400 N 9TH St FL 2
Springfield, IL 62702-5310
Mailing address
PO Box 19639
Springfield, IL 62794-9639
Phone (217) 545-8000
Other practice location 1
1000 Oakland Dr
Kalamazoo, MI 49008-1282
Phone (269) 337-6400
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.173832 | IL | MD | Pediatric Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Siu Physicians & Surgeons, Inc | Current | Accepting new patients | |
| Siu Physicians & Surgeons, Inc | Current | Accepting new patients | |
| Board of Trustees of Southern Illinois University | Current | Accepting new patients | |
| Pinckneyville Community Hospital | Past | Accepting new patients |
Locations
400 N 9th St
Fl 2
Springfield, IL 62702
400 N 9th St
Springfield, IL 62702
Phone (217) 545-6498
751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182
Interoperability endpoints
- mohammadbaidoun@siusm.allscriptsdirect.net
- mbaidoun84130@sih.direct-ci.com
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
-
- Rural Health Clinic/Center
- Carbondale, IL
- NPI 1215978127
-
- Durable Medical Equipment & Medical Supplies
- Springfield, IL
- NPI 1164055976
-
- Critical Access Hospital
- Pinckneyville, IL
- NPI 1689646523
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750291200000",
"number": "1871154971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19639",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627949639",
"telephone_number": "217-545-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N 9TH ST FL 2",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627025310",
"telephone_number": "217-545-8000",
"fax_number": "217-545-2303"
}
],
"practiceLocations": [
{
"address_1": "1000 Oakland Dr",
"address_purpose": "LOCATION",
"city": "Kalamazoo",
"state": "MI",
"postal_code": "490081282",
"country_code": "US",
"telephone_number": "269-337-6400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BAIDOUN",
"first_name": "MOHAMMAD",
"middle_name": "WS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-28",
"last_updated": "2025-06-19",
"certification_date": "2025-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "4351045426",
"primary": false
},
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "IL",
"license": "036.173832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.