Individual provider Active NPI

Sanjeev Puri, M.D.

  • Interventional Cardiology Physician
  • Moline, IL
National Provider Identifier
1023097839
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
036107895 Issued in IL
Practice address
1100 36TH Avenue
Moline, IL 61265
Phone
(309) 743-6700
Fax
(309) 743-6709
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 036107895 IL Primary

Addresses

Primary practice location

1100 36TH Avenue
Moline, IL 61265

Mailing address

1236 E Rusholme St Ste 300
Davenport, IA 52803-2473
Phone (563) 324-2992

Other identifiers 2

IdentifierTypeStateIssuer
3561308MedicaidIA
P00208166OtherMEDICARE RAILROAD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sanjeev.purimd.p1@direct.cvmedpc.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031204000457 IL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Other (Physician) 2769387505 Reassigns benefits to 4 organizations
I20040423000183 IA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 2769387505 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Medical Center, AledoGroup PAC ID 7315190436, 17 clinicians
Cardiovascular Medicine PLLCGroup PAC ID 2264334721, 50 clinicians
Unity HealthcareGroup PAC ID 8224931548, 65 clinicians
Trinity Medical CenterGroup PAC ID 2264337518, 97 clinicians
Genesis Health SystemGroup PAC ID 6103829338, 262 clinicians

Practice addresses (Care Compare)

1007 NW 3Rd St
Aledo, IL 61231-1317
Phone (309) 582-3701

1100 36TH Ave
Moline, IL 61265-7127
Phone (309) 743-6700

1236 E Rusholme St
Davenport, IA 52803-2473

1518 Mulberry Ave
Muscatine, IA 52761-3433

2701 17TH St
Rock Island, IL 61201-5351

409 NW 9TH Ave
Aledo, IL 61231-1258
Phone (309) 582-3701

4500 Utica Ridge Rd
Bettendorf, IA 52722-1626
Phone (563) 742-5000

500 John Deere Rd
Moline, IL 61265-6892
Phone (309) 779-5000

801 Illini Dr
Silvis, IL 61282-1804
Phone (309) 281-4000

Hospital & facility affiliations

  • Trinity Rock Island Hospital, Rock Island, IL, CCN 140280
  • Hammond Henry Hospital Hospital, Geneseo, IL, CCN 141319
  • Genesis HLTH System Dba Genesis MDL Ctr-Illini Hospital, Silvis, IL, CCN 140275
  • Trinity - Bettendorf Hospital, Bettendorf, IA, CCN 160104
  • Genesis Medical Center, Aledo Hospital, Aledo, IL, CCN 141304

Merit-based Incentive Payment System (MIPS)

Final score
82.95 of 100Reported as group
Quality
70.54
Promoting interoperability
97
Improvement activities
40
Cost
75.13

Merit-based Incentive Payment System (MIPS)

Final score
34.85 of 100Reported as group
Quality
21.4
Improvement activities
0
Cost
76.92

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting49
Varicose vein removal19
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
Genesis Medical Center, Aledo Current Accepting new patients
Unity Healthcare Current Accepting new patients
Genesis Medical Center, Aledo CurrentSince Feb 1, 2013 Accepting new patients
Genesis Health System CurrentSince Jul 1, 2006 Accepting new patients
Trinity Medical Center Current Accepting new patients
Genesis Medical Center, Aledo CurrentSince Feb 1, 2013 Accepting new patients
Jeffrey S. Leider, MD,PC Past Accepting new patients

Locations

4500 Utica Ridge Rd
Bettendorf, IA 52722
Phone (563) 742-2724

1227 E Rusholme St
Davenport, IA 52803
Phone (563) 324-8160

1518 Mulberry Ave
Muscatine, IA 52761
Phone (563) 262-4110

1007 NW 3rd St
Aledo, IL 61231
Phone (309) 582-3701

409 NW 9th Ave
Aledo, IL 61231
Phone (309) 582-2227

2701 17th St
Rock Island, IL 61201
Phone (309) 779-3200

801 Illini Dr
Silvis, IL 61282
Phone (309) 281-4000

Interoperability endpoints

  • Direct secure messaging: spuri92444@direct.unitypoint.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1023097839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1236 E RUSHOLME ST STE 300",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032473",
            "telephone_number": "563-324-2992",
            "fax_number": "563-324-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 36TH AVENUE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "61265",
            "telephone_number": "309-743-6700",
            "fax_number": "309-743-6709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURI",
        "first_name": "SANJEEV",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036107895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3561308",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00208166",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sanjeev.purimd.p1@direct.cvmedpc.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1100 36th Avenue",
            "city": "Moline",
            "state": "IL",
            "country_code": "US",
            "postal_code": "61265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

Verify at the official NPI Registry.