Active NPI
Clementina Asamoah, MD
- Obstetrics & Gynecology Physician
- Bourbonnais, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 036169741
- Practice address
- 338 Larry Power Rd
Bourbonnais, IL 60914-4430 - Phone
- (815) 935-4651
- NPI assigned
- Apr 23, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 036169741 | IL | Primary |
Addresses
Primary practice location
338 Larry Power Rd
Bourbonnais, IL 60914-4430
Mailing address
338 Larry Power Rd
Bourbonnais, IL 60914-4430
Phone (815) 935-4651
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
105 S 1St St
Willmington, IL 60481-8973
Phone (815) 476-5210
338 Larry Power Rd
Bourbonnais, IL 60914-4430
Phone (815) 935-2991
350 N Wall St 4TH Floor
Kankakee, IL 60901-2901
Phone 81593316714592
375 N Wall St
P520
Kankakee, IL 60901-3493
Phone (815) 933-0194
Hospital & facility affiliations
- Riverside Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Health System | Current | Accepting new patients | |
| Riverside Health System | Current | Accepting new patients | |
| University Physician Group | Past | Accepting new patients |
Locations
300 Riverside Dr
Ste 2100
Bourbonnais, IL 60914
Phone (815) 928-9666
338 Larry Power Rd
Bourbonnais, IL 60914
Phone (815) 935-2991
350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500
105 S First St
Wilmington, IL 60481
Phone (815) 476-5210
Interoperability endpoints
- casamoah50357@direct.riversidehealthcare.net
Organizations & group practices 3
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.
-
- General Practice Physician
- Kankakee, IL
- NPI 1417061193
-
- Psychiatry Physician
- Kankakee, IL
- NPI 1336354430
-
- Social Worker
- Livonia, MI
- NPI 1154360402
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Kankakee, IL
- NPI 1538208210
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722211200000",
"number": "1043830698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "338 LARRY POWER RD",
"city": "BOURBONNAIS",
"state": "IL",
"postal_code": "609144430",
"telephone_number": "815-935-4651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "338 LARRY POWER RD",
"city": "BOURBONNAIS",
"state": "IL",
"postal_code": "609144430",
"telephone_number": "815-935-4651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ASAMOAH",
"first_name": "CLEMENTINA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-23",
"last_updated": "2024-07-29",
"certification_date": "2024-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IL",
"license": "036169741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bourbonnais, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.