Individual provider Active NPI

Sarah L Camacho, PA

  • Physician Assistant
  • Springfield, IL
National Provider Identifier
1902294754
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085005398 Issued in IL
Practice address
3132 Old Jacksonville Rd Ste 200
Springfield, IL 62704-7401
Phone
(217) 862-0800
Fax
(217) 862-0871
NPI assigned
Jan 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085005398 IL Primary

Addresses

Primary practice location

3132 Old Jacksonville Rd Ste 200
Springfield, IL 62704-7401

Mailing address

3132 Old Jacksonville Rd Ste 200
Springfield, IL 62704-7401
Phone (217) 862-0800

Other practice location 1

1025 S 6th St
Springfield, IL 62703-2403
Phone (217) 528-7541

Other identifiers 1

IdentifierTypeStateIssuer
085.005398OtherILPA LICENSE

Other names 1

  • Sarah L Blank Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150317002514 IL Practitioner - Physician Assistant 2860719572 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mississippi Medical College, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorial Physician ServicesGroup PAC ID 9032005681, 161 clinicians

Practice addresses (Care Compare)

101 E Plummer Blvd
Chatham, IL 62629-8047
Phone (217) 588-2600

3132 Old Jacksonville Rd
Springfield, IL 62704-7401

Hospital & facility affiliations

  • Memorial Medical Center Hospital, Springfield, IL, CCN 140148
  • Taylorville Memorial Hospital Hospital, Taylorville, IL, CCN 141339

Merit-based Incentive Payment System (MIPS)

Final score
79.44 of 100Reported as group
Quality
71.79
Promoting interoperability
77
Improvement activities
40
Cost
75.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085005398ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Center of Chatham, LLC Current Accepting new patients
Memorial Physician Services Physician Assistant CurrentSince Nov 15, 2021 Accepting new patients
Memorial Physician Services CurrentSince Nov 15, 2021 Accepting new patients
Memorial Health Partners Current Accepting new patients
Springfield Clinic LLP Current Accepting new patients
HSHS Medical Group Inc CurrentSince Mar 1, 2015 Accepting new patients
HSHS Medical Group Inc CurrentSince Mar 1, 2015 Accepting new patients
Memorial Expresscare, LLC Past Accepting new patients

Locations

101 E Plummer Blvd
Chatham, IL 62629
Phone (217) 483-3487

345 N Main St
Chatham, IL 62629
Phone (217) 483-3333

1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889

1025 S 6th St
Springfield, IL 62703

3132 Old Jacksonville Rd
Ste 200
Springfield, IL 62704
Phone (217) 862-0800

Interoperability endpoints

  • Direct secure messaging: sarahblank@memorial.allscriptsdirect.net
  • Direct secure messaging: sarahblank@sfc.allscriptsdirect.net

Organizations & group practices 10

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 2

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": "1420156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1902294754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3132 OLD JACKSONVILLE RD STE 200",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047401",
            "telephone_number": "217-862-0800",
            "fax_number": "217-862-0871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3132 OLD JACKSONVILLE RD STE 200",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047401",
            "telephone_number": "217-862-0800",
            "fax_number": "217-862-0871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 S 6th St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627032403",
            "country_code": "US",
            "telephone_number": "217-528-7541",
            "fax_number": "217-753-0815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "SARAH",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-02",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "085.005398",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "BLANK",
            "middle_name": "L",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.