Individual provider Active NPI

Asya Segalene, M.D.

  • Allergy Physician
  • Naperville, IL
National Provider Identifier
1053391094
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
036096611 Issued in IL
Practice address
1020 E Ogden Ave
Suite 205
Naperville, IL 60563-8609
Phone
(630) 852-4050
Fax
(630) 428-9764
NPI assigned
Jan 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X 036096611 IL Primary

Addresses

Primary practice location

1020 E Ogden Ave
Suite 205
Naperville, IL 60563-8609

Mailing address

1020 E Ogden Ave
Suite 205
Naperville, IL 60563-8609
Phone (630) 852-4050

Other identifiers 1

IdentifierTypeStateIssuer
0360966114MedicaidIL

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
I20110118000573 IL Practitioner - Allergy/Immunology 1557550860

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1020 E Ogden Ave
Suite 205
Naperville, IL 60563-8610

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036096611ILMDAllergy Physician

Interoperability endpoints

  • Direct secure messaging: segalene.asya.020.0090427@avh.meditab.direct-ci.com

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": "1324425600000",
    "number": "1053391094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 E OGDEN AVE",
            "address_2": "SUITE 205",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638609",
            "telephone_number": "630-852-4050",
            "fax_number": "630-428-9764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 E OGDEN AVE",
            "address_2": "SUITE 205",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605638609",
            "telephone_number": "630-852-4050",
            "fax_number": "630-428-9764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGALENE",
        "first_name": "ASYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2011-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "IL",
            "license": "036096611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360966114",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.