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BRYAN MICHAEL MISTRETTA DO
NPI 1932722006
Colon & Rectal Surgery in Springfield, IL

Active since May 25, 2020PECOS Enrolled
315 W CARPENTER ST, SPRINGFIELD, IL 62702(217) 545-8000(217) 545-0952 Get Directions Write a Review

NPPES record last updated: August 7, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 7, 2026, May 25, 2020 (2 updates tracked since 2020).

About Bryan Michael Mistretta Do NPPES

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

BRYAN MICHAEL MISTRETTA DO (NPI 1932722006) is an individual colon & rectal surgery provider in Springfield, Illinois, licensed in Illinois (036174964) and active in the NPI registry since May 2020. He is enrolled in Medicare PECOS, maintains a secondary practice location in Springfield, and is a graduate of Kansas City University Of Med & Biosciences, College Of Osteo Med (2020).

NPPES Registry Identity

NPI1932722006
Entity TypeIndividualMale
Primary Taxonomy208C00000X
Provider Legal NameBRYAN MICHAEL MISTRETTACredential: DO
Location Address315 W CARPENTER STSpringfield, IL 62702-4901
Mailing AddressPo Box 19638Springfield, IL 62794-9638
Phone(217) 545-8000
Fax(217) 545-0952
Sole ProprietorNo
Medical School CMSKansas City University Of Med & Biosciences, College Of Osteo MedGraduated 2020
Enumeration DateMay 25, 2020
Last NPPES UpdateAugust 7, 20262 updates tracked since enumeration
NPPES CertifiedAugust 7, 2026
✔ NPI 1932722006 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyColon & Rectal SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208C00000X
License✔ Licensed in IL · 036174964
Definition
A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.
Also ListedSurgeryTaxonomy 208600000X · License 125076122 (IL)
315 W CARPENTER ST, Springfield, IL 62702
Open in Google Maps ↗

Secondary Practice Location 1

Location 1701 N 1st St Ste D327Springfield, IL 62702-3757 · Phone (217) 545-8444 · Fax (217) 545-7762

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bryan Michael Mistretta Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3072936624
PECOS Enrollment IDI20260810003422
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 Reassignment

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

Siu Physicians & Surgeons, Inc
0.4 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

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62702 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

ASHLEY RACHEL MOHAN DO
Internal Medicine (Hematology & Oncology)
315 W CARPENTER ST
SPRINGFIELD, IL 62702
Sangamon County (217) 545-8000
IMRAN HASSAN M.D.
Colon & Rectal Surgery
315 W CARPENTER ST, 2 ND FLOOR
SPRINGFIELD, IL 62702
Sangamon County (217) 545-1025
DR. HAYDEN ELISE ROTRAMEL MD
Internal Medicine (Gastroenterology)
315 W CARPENTER ST
SPRINGFIELD, IL 62702
Sangamon County (217) 545-8000
MUAATAZ AZZAWI
Internal Medicine (Gastroenterology)
315 W CARPENTER ST
SPRINGFIELD, IL 62702
Sangamon County (217) 545-8000
THERESA M BOLEY CFNP
Nurse Practitioner (Family)
315 W CARPENTER ST, 2ND FLOOR
SPRINGFIELD, IL 62702
Sangamon County (217) 545-7422
STEPHEN R HAZELRIGG M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
315 W CARPENTER ST, 2ND FLOOR
SPRINGFIELD, IL 62702
Sangamon County (217) 545-7422
MARY CATHERINE BRANDT MD
Surgery
315 W CARPENTER ST
SPRINGFIELD, IL 62702
Sangamon County (217) 545-8000
KYUNGSUK JUNG MD MPH
Internal Medicine (Hematology & Oncology)
315 W CARPENTER ST, CLINIC B
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 Bryan Mistretta's NPI number?

The NPI number for Bryan Mistretta is 1932722006. It was assigned to this individual provider in the NPPES registry on May 25, 2020.

Where is Bryan Mistretta located?

Bryan Mistretta practices at 315 W Carpenter St, Springfield, IL 62702. The listed phone number is (217) 545-8000.

What is Bryan Mistretta's specialty?

The primary specialty registered for this NPI is Colon & Rectal Surgery with taxonomy code 208C00000X.

Is Bryan Mistretta enrolled in Medicare?

Yes. Bryan Mistretta is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Bryan Mistretta's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Bryan Mistretta reassigns Medicare benefits to Siu Physicians & Surgeons, Inc (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 Bryan Mistretta'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 Bryan Mistretta was last updated on August 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.