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PELE BOUTROUS DINA M.D
NPI 1275898116
Pediatrics - Neonatal-Perinatal Medicine in Springfield, IL

Active since July 06, 2012PECOS Enrolled
415 N 9TH ST # 4W16, SPRINGFIELD, IL 62702(217) 545-8000(217) 757-6844 Get Directions Write a Review

NPPES record last updated: May 16, 2018. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Pele Boutrous Dina M.d NPPES

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

PELE BOUTROUS DINA M.D (NPI 1275898116) is an individual neonatal-perinatal medicine provider in Springfield, Illinois, licensed in Illinois (036-138186) and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1275898116
Entity TypeIndividualMale
Primary Taxonomy2080N0001X
Provider Legal NamePELE BOUTROUS DINACredential: M.D
Location Address415 N 9TH ST # 4W16Springfield, IL 62702
Mailing AddressPo Box 19676Springfield, IL 62794-9676 · (217) 545-8000 · Fax (217) 757-6844
Phone(217) 545-8000
Fax(217) 757-6844
Sole ProprietorNo
Enumeration DateJuly 6, 2012
Last NPPES UpdateMay 16, 2018
✔ NPI 1275898116 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Neonatal-Perinatal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080N0001X
License✔ Licensed in IL · 036-138186
Definition
A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.
415 N 9TH ST # 4W16, Springfield, IL 62702
Open in Google Maps ↗

Other Identifiers 1

Other036-138186IL · State License

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pele Boutrous Dina M.d is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Pele Dina reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Siu Physicians & Surgeons, Inc
0.5 mi
Endocrinology, Diabetes & Metabolism
201 E MADISON ST STE 328
Springfield, IL 62702
  • Reassigned Medicare billing, Illinois enrollment
  • 645 clinicians in this Medicare group
NPI 1558385989 (217) 545-8000
St Francis Hospital Of The Hospital Sisters Of The Third Order Of St F
43 mi
Critical Access
1215 FRANCISCAN DR
Litchfield, IL 62056
  • Reassigned Medicare billing, Illinois enrollment
  • 60 clinicians in this Medicare group
NPI 1326057076 (217) 324-8500

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 3

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

JULIE MICHELLE LIVINGSTON NNP-BC
Nurse Practitioner (Neonatal, Critical Care)
415 N 9TH ST # 4W16
SPRINGFIELD, IL 62702
Sangamon County (217) 545-8000
LAUREN AILEEN BUNNER CPNP-PC
Nurse Practitioner (Pediatrics)
415 N 9TH ST # 4W16
SPRINGFIELD, IL 62702
Sangamon County (217) 545-8000
DR. BRYAN EDWARD COMBS M.D.
Pediatrics (Pediatric Critical Care Medicine)
415 N 9TH ST # 4W16
SPRINGFIELD, IL 62702
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 Pele Dina's NPI number?

The NPI number for Pele Dina is 1275898116. It was assigned to this individual provider in the NPPES registry on July 6, 2012.

Where is Pele Dina located?

Pele Dina practices at 415 N 9th St # 4w16, Springfield, IL 62702. The listed phone number is (217) 545-8000.

What is Pele Dina's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Is Pele Dina enrolled in Medicare?

Yes. Pele Dina is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Pele Dina's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Pele Dina reassigns Medicare benefits to 2 organizations: Siu Physicians & Surgeons, Inc (Springfield, IL) and St Francis Hospital Of The Hospital Sisters Of The Third Order Of St F (Litchfield, IL). Each 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 Pele Dina'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 Pele Dina was last updated on May 16, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.