ROSS MANSFIELD – Adult Health Nurse Practitioner, NPI 1215722764

ROSS MANSFIELD is a healthcare provider. based in Mahomet, Illinois. specializing in NURSE PRACTITIONER. They hold a License No. 209031943 (IL). The NPI Number for ROSS MANSFIELD is 1215722764

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
ROSS MANSFIELD
NPI
1215722764
Phone
Not provided
Address
1205 COZZENE DR
Enumeration Date
14 April 2025
Last Update Date
14 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2174435000
Graduation Year
2024 (2 years ago)
PAC ID
0446753289
Group Practice PAC ID
2567802556
Professional Enrollment ID
I20250909004335
Address ID
IL618323752DA812XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for ROSS MANSFIELD

  • 1205 COZZENE DR

    MAHOMET, IL 618533731

    Phone:

    Type: Mailing

  • 812 N LOGAN AVE

    DANVILLE, IL 618323752

    Phone: (217) 443-5000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-09-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250909004335INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61853)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2567802556View full group profile
NameSpecialtyState
Emergency MedicineMI
Nurse PractitionerIL
Emergency MedicineIL
Emergency MedicineMI
Emergency MedicineIL
Emergency MedicineMI
Family Practice, Emergency MedicineIL
Emergency MedicineMD
Nurse PractitionerIL
Internal Medicine, Emergency MedicineIL

Reviews

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Frequently asked questions

What NPI should I save for ROSS MANSFIELD?
Save NPI 1215722764 if you need a stable reference for ROSS MANSFIELD.
Is ROSS MANSFIELD currently active in the NPI registry?
CMS-published data lists ROSS MANSFIELD as an active registrant.
Does ROSS MANSFIELD list a primary specialty?
If you are matching referrals, note Adult Health Nurse Practitioner for ROSS MANSFIELD. Clinical services aligned with this taxonomy classification.
What location metadata exists for ROSS MANSFIELD?
The page summarizes Mahomet, Illinois for ROSS MANSFIELD; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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