Active NPI 1346569480 Individual Practitioner Male Practitioner

Dr. Robert Henry Blackwell , MD

Urology • Springfield, IL

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Robert Blackwell, MD is a certified Urology practicing in Springfield, IL. With approximately 16 years of clinical experience since graduating from Northwestern University Feinberg Medical School in 2010, Dr. Blackwell delivers high-quality medical care to the local community at 301 N 8TH ST.

Dr. Blackwell is affiliated with Siu Physicians And Surgeons Inc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, diagnostic exam of bladder and urethra using an endoscope, imaging of urinary tract. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

301 N 8th St
Pav 4b

Springfield, IL 627011041

Telephone 2175458000

Fax 2175457305

Associated Practice Facility / Clinic

🏢 Pavilion Pharmacy Llc Facility NPI 1851362230

Medicare Profile & Education

Medical School

Northwestern University Feinberg Medical School

Graduation Year

2010

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Urology in Springfield, IL

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

16 Yrs -3.9 yrs vs City Avg

City Avg: 19.9 Yrs

State Avg: 26.7 Yrs

Regional Practice Density

37 Specialists

Practicing in Springfield, IL (663 Statewide)

Telehealth Adoption Rate

18.9% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

88.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Blackwell (16 Years) 16 Yrs

Springfield Specialty Average (19.9 Years) 19.9 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	167	154	$360.13	$122.39
52000 Diagnostic exam of bladder and urethra using an endoscope	101	72	$746.37	$218.50
74420 Imaging of urinary tract	96	73	$109.30	$23.09
81003 Automated urinalysis test	79	70	$18.00	$2.20
99213 Established patient office or other outpatient visit, typically 15 minutes	78	77	$252.51	$86.33
55700 Biopsy of prostate gland	77	77	$737.87	$124.43
76872 Ultrasound scan of pelvic region through rectum	73	72	$300.78	$30.60
52332 Insertion of stent in urinary duct (ureter) using an endoscope	71	51	$2305.63	$128.89
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	69	66	$376.10	$125.11
99231 Follow-up hospital inpatient care per day, typically 15 minutes	58	33	$144.17	$47.96
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	56	36	$228.61	$75.67
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	48	47	$505.71	$172.86
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	41	41	$475.66	$160.32
55876 Placement of device in prostate for radiation therapy	27	27	$506.70	$51.10
55874 Injection of biodegradable material next to prostate	26	26	$9500.85	$158.43
52356 Crushing of stone of ureter with insertion of stent using an endoscope	18	18	$4750.00	$412.51
52235 Destruction and/or removal of growth of bladder and urethra using an endoscope, 2.0-5.0 cm	15	15	$3927.00	$270.61
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	15	15	$504.00	$166.78
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	14	14	$262.00	$28.96
99443 Telephone medical discussion with physician, 21-30 minutes	13	12	$365.77	$122.46
52351 Diagnostic examination of the bladder, bladder canal (urethra), and urinary duct (ureter) or kidney using an endoscope	13	13	$3960.92	$304.05
52005 Insertion of tube into ureter using an endoscope through bladder area	13	13	$981.54	$117.70
51798 Ultrasound measurement of bladder capacity after voiding	12	12	$288.00	$10.27
55866 Surgical removal of prostate and surrounding lymph nodes using an endoscope	12	12	$6423.45	$1164.19
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	12	12	$1548.67	$297.81

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	107	100	$365.00	$122.62
76872 Ultrasound scan of pelvic region through rectum	107	102	$257.00	$31.58
52000 Diagnostic exam of bladder and urethra using an endoscope	107	72	$673.00	$225.21
55700 Biopsy of prostate gland	106	104	$685.00	$128.63
74420 Imaging of urinary tract	84	62	$110.26	$23.99
81003 Automated urinalysis test	79	71	$18.00	$2.18
99231 Follow-up hospital inpatient care per day, typically 15 minutes	74	45	$145.00	$49.53
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	72	68	$378.74	$127.96
99213 Established patient office or other outpatient visit, typically 15 minutes	66	63	$257.00	$87.76
52332 Insertion of stent in urinary duct (ureter) using an endoscope	62	46	$2392.10	$124.70
52356 Crushing of stone of ureter with insertion of stent using an endoscope	27	23	$4500.00	$408.90
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	26	18	$230.00	$78.34
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	21	21	$478.00	$162.86
52234 Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm	17	16	$2356.00	$235.63
53854 Destruction of prostate tissue accessed through urethra using radiofrequency generated water vapor heat therapy	16	16	$11815.00	$363.65
51798 Ultrasound measurement of bladder capacity after voiding	15	14	$288.00	$10.00
52351 Diagnostic examination of the bladder, bladder canal (urethra), and urinary duct (ureter) or kidney using an endoscope	14	13	$3678.00	$286.69
55866 Surgical removal of prostate and surrounding lymph nodes using an endoscope	14	14	$6516.00	$1184.55
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	14	14	$512.00	$174.51
52005 Insertion of tube into ureter using an endoscope through bladder area	12	12	$938.00	$124.30
99221 Initial hospital inpatient care per day, typically 30 minutes	12	11	$243.00	$82.98
38571 Removal of lymph nodes of both sides of pelvis using an endoscope	12	12	$11013.00	$329.20

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	151	145	$207.00	$125.64
52000 Diagnostic exam of bladder and urethra using an endoscope	150	103	$641.00	$237.71
99213 Established patient office or other outpatient visit, typically 15 minutes	128	123	$143.00	$89.21
99231 Follow-up hospital inpatient care per day, typically 15 minutes	105	57	$116.00	$38.34
52332 Insertion of stent in urinary duct (ureter) using an endoscope	97	82	$2548.29	$145.35
76872 Ultrasound scan of pelvic region through rectum	81	79	$477.44	$32.23
55700 Biopsy of prostate gland	81	80	$627.00	$128.55
81003 Automated urinalysis test	71	66	$18.00	$2.22
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	70	62	$320.00	$133.49
52356 Crushing of stone of ureter with insertion of stent using an endoscope	43	41	$4918.60	$421.06
99221 Initial hospital inpatient care per day, typically 30 minutes	35	33	$237.00	$99.87
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	22	22	$303.00	$165.17
53854 Destruction of prostate tissue accessed through urethra using radiofrequency generated water vapor heat therapy	20	20	$11815.00	$368.68
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	20	20	$262.00	$30.99
55700 Biopsy of prostate gland	20	20	$627.00	$239.44
74420 Imaging of urinary tract	18	18	$109.00	$24.43
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	17	17	$6376.00	$729.29
52352 Removal or manipulation of stone in ureter or kidney using an endoscope	17	16	$6923.65	$298.96
52351 Diagnostic examination of the bladder, bladder canal (urethra), and urinary duct (ureter) or kidney using an endoscope	16	13	$3678.00	$291.03
52204 Biopsy of the bladder using an endoscope	15	15	$1520.00	$106.52
52234 Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm	14	13	$2356.00	$233.75
51798 Ultrasound measurement of bladder capacity after voiding	13	13	$288.00	$9.94
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	12	12	$1600.00	$316.12
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$212.00	$105.84
52000 Diagnostic exam of bladder and urethra using an endoscope	11	11	$641.00	$73.48

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	191	180	$143.00	$89.52
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	166	155	$207.00	$126.68
52000 Diagnostic exam of bladder and urethra using an endoscope	161	122	$594.78	$227.16
52332 Insertion of stent in urinary duct (ureter) using an endoscope	104	84	$2397.99	$129.32
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	87	87	$303.00	$164.77
55700 Biopsy of prostate gland	78	77	$627.00	$131.71
74420 Imaging of urinary tract	72	60	$109.00	$24.91
76872 Ultrasound scan of pelvic region through rectum	68	66	$300.76	$32.82
99231 Follow-up hospital inpatient care per day, typically 15 minutes	65	34	$116.00	$38.13
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	52	12	$2250.00	$209.15
52356 Crushing of stone of ureter with insertion of stent using an endoscope	42	39	$4607.14	$413.40
99221 Initial hospital inpatient care per day, typically 30 minutes	40	36	$237.00	$100.92
81003 Automated urinalysis test	39	39	$18.00	$2.25
55700 Biopsy of prostate gland	38	38	$627.00	$245.98
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	37	37	$212.00	$110.79
53854 Destruction of prostate tissue accessed through urethra using radiofrequency generated water vapor heat therapy	35	35	$11815.00	$374.48
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	34	34	$81.00	$54.94
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	31	31	$320.00	$135.24
52204 Biopsy of the bladder using an endoscope	30	26	$1520.00	$120.48
52234 Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm	29	27	$2356.00	$247.52
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	28	28	$262.00	$31.30
52351 Diagnostic examination of the bladder, bladder canal (urethra), and urinary duct (ureter) or kidney using an endoscope	23	21	$3678.00	$292.95
52235 Destruction and/or removal of growth of bladder and urethra using an endoscope, 2.0-5.0 cm	22	20	$3927.00	$271.07
51798 Ultrasound measurement of bladder capacity after voiding	21	21	$288.00	$9.72
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	20	20	$54.00	$13.78
J1580 Injection, garamycin, gentamicin, up to 80 mg	18	18	$8.00	$1.88
52352 Removal or manipulation of stone in ureter or kidney using an endoscope	15	15	$6974.93	$348.41
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	14	12	$129.00	$31.26
52000 Diagnostic exam of bladder and urethra using an endoscope	14	11	$601.79	$72.17
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	13	13	$262.00	$31.33
55876 Placement of device in prostate for radiation therapy	12	12	$451.00	$50.34
55874 Injection of biodegradable material next to prostate	12	12	$8667.00	$164.94
52005 Insertion of tube into ureter using an endoscope through bladder area	12	12	$938.00	$115.28
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	11	11	$6376.00	$736.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	172	159	$143.00	$73.98
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	149	132	$207.00	$107.46
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	138	22	$2250.00	$223.28
99231 Follow-up hospital inpatient care per day, typically 15 minutes	125	57	$116.00	$39.83
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	122	122	$303.00	$163.77
74420 Imaging of urinary tract	114	93	$109.00	$25.77
52000 Diagnostic exam of bladder and urethra using an endoscope	112	83	$580.00	$205.17
52332 Insertion of stent in urinary duct (ureter) using an endoscope	71	60	$2548.93	$132.79
99221 Initial hospital inpatient care per day, typically 30 minutes	53	47	$237.00	$103.85
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	45	44	$320.00	$139.27
55700 Biopsy of prostate gland	43	43	$627.00	$131.21
52356 Crushing of stone of ureter with insertion of stent using an endoscope	42	39	$4821.43	$420.78
76872 Ultrasound scan of pelvic region through rectum	34	31	$257.00	$33.90
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	33	22	$129.00	$30.42
81003 Automated urinalysis test	31	31	$18.00	$2.23
51700 Simple bladder irrigation and/or instillation	29	29	$614.00	$71.28
51798 Ultrasound measurement of bladder capacity after voiding	21	20	$288.00	$9.75
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	21	21	$212.00	$106.45
52235 Destruction and/or removal of growth of bladder and urethra using an endoscope, 2.0-5.0 cm	19	18	$3927.00	$278.95
52204 Biopsy of the bladder using an endoscope	19	18	$1520.00	$137.99
52352 Removal or manipulation of stone in ureter or kidney using an endoscope	16	16	$6947.69	$360.84
51702 Simple insertion of temporary bladder tube	16	12	$1075.00	$59.93
52234 Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm	16	14	$2356.00	$255.54
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	15	14	$262.00	$32.43
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	15	15	$81.00	$44.70
52005 Insertion of tube into ureter using an endoscope through bladder area	15	13	$938.00	$119.62
55700 Biopsy of prostate gland	13	13	$627.00	$245.84
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	12	12	$6376.00	$753.42
55874 Injection of biodegradable material next to prostate	11	11	$8667.00	$171.54
55866 Surgical removal of prostate and surrounding lymph nodes using an endoscope	11	11	$6516.00	$1498.92
55876 Placement of device in prostate for radiation therapy	11	11	$451.00	$52.22
38571 Removal of lymph nodes of both sides of pelvis using an endoscope	11	11	$11013.00	$344.32

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	276	225	$207.00	$104.99
99213 Established patient office or other outpatient visit, typically 15 minutes	257	206	$143.00	$71.20
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	138	21	$2080.43	$224.58
81003 Automated urinalysis test	109	95	$18.00	$2.44
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	106	106	$303.00	$160.18
52000 Diagnostic exam of bladder and urethra using an endoscope	90	70	$580.00	$181.98
74420 Imaging of urinary tract	89	63	$109.00	$25.49
51798 Ultrasound measurement of bladder capacity after voiding	85	74	$288.00	$11.87
99231 Follow-up hospital inpatient care per day, typically 15 minutes	80	46	$116.00	$38.98
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	54	52	$320.00	$135.45
52332 Insertion of stent in urinary duct (ureter) using an endoscope	51	42	$2380.10	$128.71
51700 Simple bladder irrigation and/or instillation	51	38	$614.00	$71.46
52356 Crushing of stone of ureter with insertion of stent using an endoscope	37	30	$4621.62	$419.07
99221 Initial hospital inpatient care per day, typically 30 minutes	37	35	$237.00	$100.67
51702 Simple insertion of temporary bladder tube	34	22	$1075.00	$59.31
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	30	26	$1600.00	$261.65
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	30	21	$129.00	$29.02
55700 Biopsy of prostate gland	25	24	$627.00	$130.15
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	24	24	$215.67	$105.16
55700 Biopsy of prostate gland	24	24	$627.00	$242.21
52204 Biopsy of the bladder using an endoscope	22	21	$1520.00	$122.27
76872 Ultrasound scan of pelvic region through rectum	21	21	$540.43	$70.48
76872 Ultrasound scan of pelvic region through rectum	16	16	$257.00	$33.15
53854 Destruction of prostate tissue accessed through urethra using radiofrequency generated water vapor heat therapy	15	15	$11815.00	$352.05
52235 Destruction and/or removal of growth of bladder and urethra using an endoscope, 2.0-5.0 cm	15	15	$3927.00	$293.58
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	12	12	$262.00	$31.89
52005 Insertion of tube into ureter using an endoscope through bladder area	12	11	$938.00	$100.39
52234 Destruction and/or removal of growth of bladder and urethra using an endoscope, 0.5-2.0 cm	12	12	$2356.00	$250.54
52352 Removal or manipulation of stone in ureter or kidney using an endoscope	12	11	$7083.92	$299.48

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	182	145	$143.00	$70.13
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	112	112	$303.00	$160.81
99231 Follow-up hospital inpatient care per day, typically 15 minutes	108	49	$116.00	$38.93
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	95	86	$207.00	$103.40
81003 Automated urinalysis test	92	83	$18.00	$2.71
51798 Ultrasound measurement of bladder capacity after voiding	72	59	$288.00	$14.76
51700 Simple bladder irrigation and/or instillation	59	41	$614.00	$64.43
52000 Diagnostic exam of bladder and urethra using an endoscope	59	52	$580.00	$160.41
52332 Insertion of stent in urinary duct (ureter) using an endoscope	57	47	$2323.16	$107.27
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	56	56	$212.00	$103.61
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	50	44	$81.00	$42.23
99221 Initial hospital inpatient care per day, typically 30 minutes	48	47	$237.00	$100.89
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	37	37	$1600.00	$240.34
52356 Crushing of stone of ureter with insertion of stent using an endoscope	28	27	$4500.00	$410.03
74420 Imaging of urinary tract	26	26	$109.00	$17.42
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	25	24	$320.00	$135.62
52352 Removal or manipulation of stone in ureter or kidney using an endoscope	20	19	$6865.95	$354.62
51702 Simple insertion of temporary bladder tube	18	13	$1075.00	$61.69
52204 Biopsy of the bladder using an endoscope	12	11	$1520.00	$131.22
55700 Biopsy of prostate gland	11	11	$627.00	$115.14
52648 Laser vaporization of prostate including control of bleeding using an endoscope	11	11	$20435.00	$696.16
52005 Insertion of tube into ureter using an endoscope through bladder area	11	11	$938.00	$104.72

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
74420 Imaging of urinary tract	23	17	$109.00	$17.35
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	15	15	$212.00	$104.44
99221 Initial hospital inpatient care per day, typically 30 minutes	15	14	$237.00	$100.59
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	13	$81.00	$41.60
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	13	13	$303.00	$159.29
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	11	11	$207.00	$103.48

Medical Specialties & State Licenses

CMS Verified: 2020-10-18

Urology Primary Specialty

NUCC Taxonomy Code: 208800000X

State License IL 036138479

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Hospital & Practice Group Affiliations

Siu Physicians And Surgeons Inc

751 N Rutledge St, Springfield, IL 627024968

Phone: 2175458000

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Amanda Henson , LCSW

Social Worker - Clinical

NPI 1003247115

Licensed Clinical Social Worker

Dr. Fadel Bofarrag , MD, MPH

Internal Medicine - Cardiovascular Disease

NPI 1003291279

Doctor of Medicine (M.D.), Master of Public Health

Jerry Priddy , PA-C

Physician Assistant

NPI 1003351115

Physician Assistant (Certified)

Dr. Ashley Mohan , DO

Internal Medicine - Hematology & Oncology

NPI 1003377565

Doctor of Osteopathic Medicine (D.O.)

Dr. Linda Ponce Rosas , MD

Internal Medicine - Endocrinology, Diabetes & Metabolism

NPI 1003501065

Doctor of Medicine (M.D.)

Jay Benoit

Nurse Practitioner - Family

NPI 1003579335

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events

✅

NPI Profile Active May 01, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location May 01, 2017

Registered at 301 N 8TH ST, PAV 4B, SPRINGFIELD, IL 627011041 (Tel: 2175458000)

📍

Updated Business Mailing Address May 01, 2017

Registered at 301 N 8TH ST, PO BOX 19665, SPRINGFIELD, IL 627011041 (Tel: 2175458000)

👤

Provider Name / Credentials Updated May 01, 2017

Recorded as ROBERT BLACKWELL, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 01, 2017

Urology (License #036138479 in IL)

✅

NPI Profile Active December 29, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location December 29, 2015

Registered at 2160 S 1ST AVE, GRADUATE MEDICAL EDUCATION, MAYWOOD, IL 601533328 (Tel: 7083274663)

📍

Updated Business Mailing Address December 29, 2015

Registered at 2160S 1ST AVE, MAYWOOD, IL 601533328 (Tel: 7082169000)

👤

Provider Name / Credentials Updated December 29, 2015

Recorded as ROBERT BLACKWELL, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) December 29, 2015

Urology (License #036138479 in IL)

🟢

Initial NPI Registration & Enumeration May 28, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1346569480

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: May 28, 2010

Last Update: October 18, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

301 N 8th St, Po Box 19665

Springfield, IL 627011041

Phone: 2175458000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.