Robert Knudson
Radiology (Diagnostic Radiology)

Address: 3050 Montvale Dr Ste A, Springfield, IL 62704-6924
Phone: 2177268096

Robert Knudson (NPI# 1235170069) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1235170069
Entity Type Individual
Full Name Robert Knudson
Credential MD
Gender Male
Practice Address 3050 Montvale Dr Ste A
Springfield
IL 62704-6924
Practice Telephone 2177268096
Mailing Address 2040 W Iles Ave
Suite C
Springfield
IL 62704-4183
Mailing Telephone 2177890668
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2006-06-10
Last Update Date 2015-08-04

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 2085R0202X Radiology · Diagnostic Radiology Allopathic & Osteopathic Physicians 036109217 IL

Other Provider Identifier

State Identifier Issuer Type Code
IL 036109217 MEDICAID

Other Providers ROBERT KNUDSON

NPI Name Taxonomy Address Enumeration
1578624789 Robert L Knudson Dentist 1415 Commercial St, Bellingham, WA 98225-4309 2006-12-12
1528056207 Robert J Knudson Family Medicine 4017 Devils Glen Rd, Ste 100, Bettendorf, IA 52722-7221 2005-10-07

Physician Overview

NPI 1235170069
PAC ID by PECOS 1153318555
Professional Enrollment ID I20040428000383
Full Name Robert Knudson
Organization Legal Name SPRINGFIELD CLINIC LLP
Phone Number 2175287541
Gender M
Credential MD
Medical School UNIVERSITY OF ILLINOIS AT CHICAGO HEALTH SCIENCE CENTER
Graduation Year 1998
Primary Specialty DIAGNOSTIC RADIOLOGY
Group Practice PAC ID 0547166076
Number of Group Practice Members 474
Accepts Medicare Assignment Y
Report Quality Measures Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
140148 MEMORIAL MEDICAL CENTER
141322 ABRAHAM LINCOLN MEMORIAL HOSPITAL
141311 FAIRFIELD MEMORIAL HOSPITAL 1
140147 RICHLAND MEMORIAL HOSPITAL
141339 TAYLORVILLE MEMORIAL HOSPITAL

Individual EP (Eligible Professionals) Public Reporting – Performance Scores
Physician Quality Reporting System (PQRS) and non-PQRS Qualified Clinical Data Registry (QCDR)

Measure Identifier Measure Title Performance Rate Reporting Mechanism
PQRS_EP_145_1 Radiology: Exposure Time Reported for Procedures Using Fluoroscopy 82%
PQRS_EP_147_1 Nuclear Medicine: Correlation with Existing Imaging Studies for All Patients Undergoing Bone Scintigraphy 93%
PQRS_EP_195_1 Radiology: Stenosis Measurement in Carotid Imaging Reports 100%

Office Location

Street Address 3050 MONTVALE DR STE A
City SPRINGFIELD
State IL
Zip Code 62704-6924

Providers in the same location

NPI Name Taxonomy Address Enumeration
1164484846 Stephanie Heather Swope Radiology 3050 Montvale Dr Ste A, Springfield, IL 62704-6924 2006-04-06
1821350455 Aaron P Gould Radiology 3050 Montvale Dr Ste A, Springfield, IL 62704-6924 2012-06-11
1700172905 Robert John Talbert Radiology 3050 Montvale Dr Ste A, Springfield, IL 62704-6924 2011-06-26
1215235361 Arpit A Patel Student in an Organized Health Care Education/Training Program 3050 Montvale Dr Ste A, Springfield, IL 62704 2011-03-13
1659682524 Justin Mark Brooks Internal Medicine 3050 Montvale Dr Ste A, Springfield, IL 62704-6924 2010-06-25
1194040634 Lucas Kyle Buckley Radiology 3050 Montvale Dr Ste A, Springfield, IL 62704-6924 2010-03-27
1912232422 Alexander Ryan Radiology 3050 Montvale Dr Ste A, Springfield, IL 62704-6924 2009-10-16
1710117577 Jason Michael Cox Radiology 3050 Montvale Dr Ste A, Springfield, IL 62704-6924 2009-07-15
1003044819 Christopher John Norbet Radiology 3050 Montvale Dr Ste A, Springfield, IL 62704-6924 2009-06-30
1154556520 Andrew Barina Student in an Organized Health Care Education/Training Program 3050 Montvale Dr Ste A, Springfield, IL 62704-6924 2009-05-28
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1902394901 Hillary Haaker Occupational Therapist 2035 W Iles, Suite C, Springfield, ID 62704 2018-04-25
1871095364 Edward Doyle Slifer Sr. Pathology 2117 Greenside Drive, Spring Field, IL 62704 2018-03-01
1598263345 Santarelli & Feller Dental Group Dentist 1140 Rickard Road, Suite B, Springfield, IL 62704 2018-01-26
1447774757 Lisa Ann Rogers Developmental Therapist 2101 Lexington Dr, Apt 3, Springfield, IL 62704 2017-07-28
1730611286 Mindi Rowe Occupational Therapist 2508 County Rd 4 1/2 E, Springfield, IL 62704 2017-04-03
1366992208 Jayme Jordan Contractor 2409 Westchester Blvd, Springfield, IL 62704 2016-10-04
1154793974 Dina Payne Social Worker 917 Clocktower Drive, Suite 600, Springfield, IL 62704 2015-10-21
1942552161 Jeannie Marie Hundley Specialist/Technologist, Other 2921 Monvale Drive, Springfield, IL 62704 2012-10-11
1861742223 Victoria J. Dow General Practice 948 Clocktower Drive, Springfield, IL 62704 2012-09-13
1770868457 Walgreens Pharmacy #12427 Clinic/Center 2305 W Monroe, Springfield, IL 62704 2011-10-13
Find all providers in zip 62704

Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1407389596 Medical Mile Imaging Radiology 3905 E Windsmore Dr, Springfield, MO 65802 2017-04-06
1154738961 Allison Kate Retzer Radiology 701 N 1st Box 101, Springfield, IL 62781-0001 2014-07-14
1134552821 Clinical Radiologists, S.c. Radiology 2812 Pat Tillman Dr, Springfield, IL 62711-6410 2013-08-16
1700199668 Telerad of Mo Account Management, LLC Radiology 5117 S. Neffleton Ave, Springfield, MO 65810 2010-07-21
1982915302 William Leland Zelkovich Radiology 701 N 1st, Springfield, IL 62702 2010-06-30
1316108434 Michael C Snyder Radiology 2201 Greenside Dr, Springfield, IL 62704-3245 2008-06-20
1245416536 Mary T Peter Radiology Springfield Radiologists St Johns Hospital, 800 E. Carpenter Street, Springfield, IL 62769-0001 2008-01-16
1437361060 Kal Dulaimy Radiology 1350 Main Street Suite 1007, Radiology and Imaging, Inc., Springfield, MA 01103-0000 2007-05-04
1265654164 Nzeadibenma O Uzochukwu Radiology 800 Carpenter St, Springfield, IL 62769-0001 2007-05-02
1396865838 Charles X Stricker Radiology 4303 E Lori Lei Ct, Springfield, MO 65809-3501 2007-03-29
Find all providers in SPRINGFIELD

Competitor

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City SPRINGFIELD
Zip Code 62704

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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