Individual provider Active NPI

Dr Gurpreet S Mander, M.D.

  • Pediatric Critical Care Medicine Physician
  • Springfield, IL
National Provider Identifier
1932182656
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
Practice address
415 N 9TH St
Springfield, IL 62702-5317
Phone
(217) 544-6464
Fax
(217) 757-6844
NPI assigned
Nov 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X IL Primary

Addresses

Primary practice location

415 N 9TH St
Springfield, IL 62702-5317

Mailing address

PO Box 19639
Springfield, IL 62794-9639
Phone (217) 545-7578

Other identifiers 1

IdentifierTypeStateIssuer
087739MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20240620002167 AZ Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 3274585229 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036087739ILMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Super Specialists Arizona LLC CurrentSince May 12, 2024 Accepting new patients
Banner Physician Super Specialists Arizona LLC CurrentSince May 12, 2024 Accepting new patients

Locations

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

1432 S Dobson Rd
Ste 301
Mesa, AZ 85202
Phone (480) 412-7120

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1932182656",
    "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": "217-545-7578",
            "fax_number": "217-545-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N 9TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025317",
            "telephone_number": "217-544-6464",
            "fax_number": "217-757-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDER",
        "first_name": "DR GURPREET",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "087739",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.