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ALEXANDRA MARIE ISHMAEL LICENSED DIETITIAN
NPI 1265099758
Dietitian, Registered in Springfield, IL

Active since May 21, 2019
319 E MADISON ST STE 1F, SPRINGFIELD, IL 62701(217) 788-3948(217) 527-3209 Get Directions Write a Review

NPPES record last updated: May 21, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Alexandra Marie Ishmael Licensed Dietitian NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALEXANDRA MARIE ISHMAEL LICENSED DIETITIAN (NPI 1265099758) is an individual dietitian, registered in Springfield, Illinois and active in the NPI registry since May 2019.

NPPES Registry Identity

NPI1265099758
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameALEXANDRA MARIE ISHMAELCredential: LICENSED DIETITIAN
Location Address319 E MADISON ST STE 1FSpringfield, IL 62701-1035
Mailing AddressPo Box 3428Springfield, IL 62708-3428 · (800) 577-5368 · Fax (217) 757-2021
Phone(217) 788-3948
Fax(217) 527-3209
Sole ProprietorNo
Enumeration DateMay 21, 2019
✔ NPI 1265099758 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
319 E MADISON ST STE 1F, Springfield, IL 62701
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Other Identifiers 1

Other164007543IL · Licensed Dietitian Nutritionist License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alexandra Marie Ishmael Licensed Dietitian is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Alexandra Ishmael reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Springfield Clinic, LLP
0.9 mi
Multi-Specialty
1025 S 6TH ST
Springfield, IL 62703
  • Reassigned Medicare billing, Illinois enrollment
  • 735 clinicians in this Medicare group
NPI 1780638478 (217) 528-7541

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JAMIE WALLMAN MD
Family Medicine
319 E MADISON ST STE 1F
SPRINGFIELD, IL 62701
Sangamon County (217) 545-8000
KIMBERLY CURRIE FNP-BC
Nurse Practitioner (Family)
319 E MADISON ST STE 1F
SPRINGFIELD, IL 62701
Sangamon County (217) 545-8000
OLIVIA ANN DELAY FNP-C
Nurse Practitioner (Family)
319 E MADISON ST STE 1F
SPRINGFIELD, IL 62701
Sangamon County (217) 545-8000
JAMEY A BAIETTO RD
Dietitian, Registered
319 E MADISON ST STE 1F
SPRINGFIELD, IL 62701
Sangamon County (217) 788-3948
BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY
Clinic/Center (Federally Qualified Health Center (FQHC))
319 E MADISON ST STE 1F
SPRINGFIELD, IL 62701
Sangamon County (217) 545-8000
ELIZABETH STEERE LCPC
Counselor (Professional)
319 E MADISON ST STE 1F
SPRINGFIELD, IL 62701
Sangamon County (217) 545-8000
JESSICA E LUCCA AGACNP-BC
Nurse Practitioner (Acute Care)
319 E MADISON ST STE 1F
SPRINGFIELD, IL 62701
Sangamon County (217) 788-3948
DR. ANKIT SHARMA M.D., M.H.A.
Family Medicine
319 E MADISON ST STE 1F
SPRINGFIELD, IL 62701
Sangamon County (217) 545-8000

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 Alexandra Ishmael's NPI number?

The NPI number for Alexandra Ishmael is 1265099758. It was assigned to this individual provider in the NPPES registry on May 21, 2019.

Where is Alexandra Ishmael located?

Alexandra Ishmael practices at 319 E Madison St Ste 1F, Springfield, IL 62701. The listed phone number is (217) 788-3948.

What is Alexandra Ishmael's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Alexandra Ishmael enrolled in Medicare?

Yes. Alexandra Ishmael is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Alexandra Ishmael's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Alexandra Ishmael reassigns Medicare benefits to Springfield Clinic, LLP (Springfield, IL). The 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 Alexandra Ishmael's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Alexandra Ishmael was last updated on May 21, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.