MEMORIAL PHYSICIAN SERVICES
NPI 1174877930
Family Medicine in Springfield, IL
About Memorial Physician Services NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MEMORIAL PHYSICIAN SERVICES (NPI 1174877930) is a healthcare organization registered as a family medicine in Springfield, Illinois and active in the NPI registry since November 2012. The organization maintains a secondary practice location in Springfield and lists James T Dowell, Vice President, Mps, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 7
Secondary Practice Location 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Memorial Physician Services is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
150Medicare enrollment records show 150 clinicians reassign Medicare billing to Memorial Physician Services, which bills Medicare for the services they deliver. Of these, 30 practice at this address and 95 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 10
Nearest to this location (20)
See all 150Springfield, IL 62704
Springfield, IL 62704
Springfield, IL 62704
Springfield, IL 62704
Springfield, IL 62704
Springfield, IL 62704
Springfield, IL 62704
Springfield, IL 62704
Springfield, IL 62704
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Memorial Physician Services's NPI number?
The NPI number for Memorial Physician Services is 1174877930. It was assigned to this organization in the NPPES registry on November 1, 2012.
Where is Memorial Physician Services located?
Memorial Physician Services is located at 3132 Old Jacksonville Rd, Springfield, IL 62704. The listed phone number is (217) 862-0800.
What is Memorial Physician Services's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Memorial Physician Services enrolled in Medicare?
Yes. Memorial Physician Services is registered in the Medicare PECOS enrollment system.
When is Memorial Physician Services's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Illinois, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Memorial Physician Services?
According to the CMS Revalidation Reassignment List (October 2026 release), 150 clinicians in 10 Medicare specialties reassign their Medicare billing to Memorial Physician Services. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (93), Family Practice (26) and Psychiatry (10). Of these, 30 practice at this address and 95 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Memorial Physician Services was last updated on June 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Memorial Physician Services · NPI 1174877930
Family Medicine organization in Springfield, Illinois. Organization record, active in the CMS NPPES registry since November 1, 2012.
## Identity
- **NPI:** 1174877930 (Entity type: Organization)
- **Enumerated:** November 1, 2012
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** James Dowell, VICE PRESIDENT, MPS
## Practice location
- **Address:** 3132 OLD JACKSONVILLE RD, Springfield, IL 62704-7400
- **Phone:** (217) 862-0800 · **Fax:** (217) 862-0871
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Illinois, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 150 clinicians in 10 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (93), Family Practice (26), Psychiatry (10); 30 practice at this address and 95 within 10 miles; [full list](https://npiprofile.com/npi/1174877930/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 11, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1174877930) · Data from the CMS NPPES public registry.