1. Home
  2. Directory
  3. Illinois
  4. Springfield
  5. Orthopaedic Surgery
  6. NPI Profile

STEPHEN J PINEDA MD
NPI 1528178654
Orthopaedic Surgery - Orthopaedic Surgery of the Spine in Springfield, IL

Active since August 30, 2006PECOS EnrolledAccepts Medicare Assignment
800 N. 1ST ST., SPRINGFIELD, IL 62702(217) 528-7541(217) 753-5854 Get Directions Write a Review

NPPES record last updated: May 20, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Stephen J Pineda Md NPPES

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

STEPHEN J PINEDA MD (NPI 1528178654) is an individual orthopaedic surgery of the spine provider in Springfield, Illinois, licensed in Illinois (036-095441) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with St Johns Hospital, and is a graduate of Columbia University College Of Physicians And Surgeons (1990).

NPPES Registry Identity

NPI1528178654
Entity TypeIndividualMale
Primary Taxonomy207XS0117X
Provider Legal NameSTEPHEN J PINEDACredential: MD
Location Address800 N. 1ST ST.Springfield, IL 62702
Mailing Address1025 S 6th StSpringfield, IL 62703-2403 · (217) 528-7541
Phone(217) 528-7541
Fax(217) 753-5854
Sole ProprietorNo
Medical School CMSColumbia University College Of Physicians And SurgeonsGraduated 1990
Enumeration DateAugust 30, 2006
Last NPPES UpdateMay 20, 2020
NPPES CertifiedMay 20, 2020
✔ NPI 1528178654 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Orthopaedic Surgery of the SpineAllopathic & Osteopathic Physicians
Taxonomy Code207XS0117X
License✔ Licensed in IL · 036-095441
Definition
Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive.
800 N. 1ST ST., Springfield, IL 62702
Open in Google Maps ↗

Other Identifiers 1

Medicaid036095441IL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Stephen J Pineda Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42230567
PECOS Enrollment IDI20060118000609
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 Stephen Pineda reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Springfield Clinic, LLP
1.4 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
Carle Health Medical Group
79 mi
Internal Medicine
611 W PARK ST
Urbana, IL 61801
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Carle Health Care Incorporated
  • 2,516 clinicians in this Medicare group
NPI 1154653947 (217) 383-8300

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

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
72 services63 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
68 services59 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
41 services41 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
29 services29 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
22 services22 patients
New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202
This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
14 services14 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Johns Hospital

Acute Care Hospitals · Springfield, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140053
Location800 E Carpenter StSpringfield, IL 62769 · Sangamon County
Emergency services Birthing friendly

Mc Donough District Hospital

Acute Care Hospitals · Macomb, IL
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number140089
Location525 East Grant StreetMacomb, IL 61455 · Mc Donough County
Emergency services Birthing friendly

Memorial Medical Center

Acute Care Hospitals · Springfield, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140148
Location701 N First StSpringfield, IL 62702 · Sangamon County
Emergency services Birthing friendly

Abraham Lincoln Memorial Hospital

Critical Access Hospitals · Lincoln, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number141322
Location200 Stahlhut DriveLincoln, IL 62656 · Logan County
Emergency services

Taylorville Memorial Hospital

Critical Access Hospitals · Taylorville, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number141339
Location201 East Pleasant StreetTaylorville, IL 62568 · Christian County
Emergency services

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 Stephen Pineda's NPI number?

The NPI number for Stephen Pineda is 1528178654. It was assigned to this individual provider in the NPPES registry on August 30, 2006.

Where is Stephen Pineda located?

Stephen Pineda practices at 800 N. 1st St., Springfield, IL 62702. The listed phone number is (217) 528-7541.

What is Stephen Pineda's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Orthopaedic Surgery of the Spine, with taxonomy code 207XS0117X.

Is Stephen Pineda enrolled in Medicare?

Yes. Stephen Pineda is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Stephen Pineda's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Stephen Pineda reassigns Medicare benefits to 2 organizations: Springfield Clinic, LLP (Springfield, IL) and Carle Health Medical Group (Urbana, 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 Stephen Pineda's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Stephen Pineda affiliated with any hospitals?

According to CMS data, Stephen Pineda is affiliated with St Johns Hospital, Mc Donough District Hospital, Memorial Medical Center, Abraham Lincoln Memorial Hospital and Taylorville Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Stephen Pineda was last updated on May 20, 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.