Individual provider Active NPI

James L Wade III, M.D.

  • Medical Oncology Physician
  • Decatur, IL
National Provider Identifier
1992774459
Registry record updated Feb 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
036059192 Issued in IL
Practice address
210 W. McKinley Ave
Ste 1
Decatur, IL 62526
Phone
(217) 876-6600
Fax
(217) 876-6606
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 036059192 IL Primary

Addresses

Primary practice location

210 W. McKinley Ave
Ste 1
Decatur, IL 62526

Mailing address

PO Box 25228
Decatur, IL 62525-5228
Phone (217) 877-9442

Other identifiers 1

IdentifierTypeStateIssuer
036059192MedicaidIL

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
I20041229000203 IL Practitioner - Medical OncologyPractitioner - Internal MedicinePractitioner - Hematology/Oncology 8325952559 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2004 Accepting new patients
Cancer Care Specialists of Central Illinois, S.C. Medical Oncology CurrentSince Aug 2, 1979 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2004 Accepting new patients
Cancer Care Specialists of Central Illinois, S.C CurrentSince Aug 2, 1979 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

38205 Eagle Way
Chicago, IL 60678

210 W McKinley Ave
#1
Decatur, IL 62526
Phone (217) 877-9442

210 W McKinley Ave
Ste 1
Decatur, IL 62526
Phone (217) 876-6600

905 Medical Park Dr
Effingham, IL 62401
Phone (217) 342-2066

201 E Pleasant St
Taylorville, IL 62568
Phone (217) 707-5555

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.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393372800000",
    "number": "1992774459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25228",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625255228",
            "telephone_number": "217-877-9442",
            "fax_number": "217-233-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W. MCKINLEY AVE",
            "address_2": "STE 1",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "62526",
            "telephone_number": "217-876-6600",
            "fax_number": "217-876-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "JAMES",
        "middle_name": "L",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2014-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "IL",
            "license": "036059192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036059192",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.