Individual provider Active NPI

Anthony Molinari, MD

  • Internal Medicine Physician
  • Belvidere, IL
National Provider Identifier
1043290158
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036054017 Issued in IL
Practice address
1954 Gateway Center Dr
Belvidere, IL 61008-9303
Phone
(815) 544-7400
NPI assigned
Jan 17, 2006
Last updated
Oct 2, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036054017 IL Primary

Addresses

Primary practice location

1954 Gateway Center Dr
Belvidere, IL 61008-9303

Mailing address

1954 Gateway Center Dr
Belvidere, IL 61008-9303
Phone (815) 544-7400

Other identifiers 1

IdentifierTypeStateIssuer
036054017MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040818000181 IL Practitioner - Internal Medicine 2567435795 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036054017ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients

Locations

1954 Gateway Center Dr
Belvidere, IL 61008
Phone (815) 544-7400

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

5666 E State St
Rockford, IL 61108
Phone (815) 226-2000

6830 Villagreen Vw
Rockford, IL 61107
Phone (815) 282-1339

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443744000000",
    "number": "1043290158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1954 GATEWAY CENTER DR",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610089303",
            "telephone_number": "815-544-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1954 GATEWAY CENTER DR",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610089303",
            "telephone_number": "815-544-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINARI",
        "first_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2015-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036054017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036054017",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belvidere, IL

Sources for this page

Verify at the official NPI Registry.