NPIMap

Individual provider Active NPI

Nanthini Suthan, M.D

  • Internal Medicine Physician
  • Highland, IL
National Provider Identifier
1053504506
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036126643 Issued in IL
Practice address
12860 Troxler Ave
Highland, IL 62249-2898
Phone
(618) 651-2810
NPI assigned
Aug 18, 2007
Last updated
Feb 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 059772 GA
Internal Medicine Physician 207R00000X 036126643 IL Primary

Addresses

Primary practice location

12860 Troxler Ave
Highland, IL 62249-2898

Mailing address

12860 Troxler Ave
Highland, IL 62249-2898

Other practice location 1

2 Terminal Dr
Suite 8
East Alton, IL 62024-2201
Phone (618) 258-0485

Other identifiers 1

IdentifierTypeStateIssuer
448758879AOtherGAPEACHCARE FOR KIDS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nsuthan106199@ewd.direct.hshs.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110223000798 IL Practitioner - Internal Medicine 7719073816 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HSHS Medical Group IncGroup PAC ID 5092857821, 212 clinicians
St Josephs Hospital of the Hospital Sisters of the Third Order of St FGroup PAC ID 4183617517, shared by 2 NPIs, 26 clinicians

Practice addresses (Care Compare)

12860 Troxler Ave
Highland, IL 62249-2806
Phone (618) 651-2810

12866 Troxler Ave
Highland, IL 62249-2806
Phone (618) 651-2600

1512 N Green Mount Rd
Suite 108
Ofallon, IL 62269-1953
Phone (618) 624-5510

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Medical Group Inc CurrentSince Feb 1, 2025 Accepting new patients
SJL Health Systems Inc CurrentSince Feb 1, 2025 Accepting new patients
Southern Illinois Health Care Foundation, Inc. Internal Medicine CurrentSince Mar 18, 2013 Accepting new patients
Southern Illinois Healthcare Foundation Inc Internal Medicine Current Accepting new patients
Southern Illinois Healthcare Foundation Inc CurrentSince Mar 18, 2013 Accepting new patients
HSHS Medical Group Inc Current Accepting new patients
Careconnect Health, Inc. Past Accepting new patients
HSHS Medical Group Inc Past Accepting new patients

Locations

1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889

2 Terminal Dr
Ste 8
East Alton, IL 62024
Phone (618) 258-0485

2001 State St
East St Louis, IL 62205
Phone (618) 271-0204

12860 Troxler Ave
Highland, IL 62249
Phone (618) 235-3687

1512 N Green Mount Rd
O Fallon, IL 62269
Phone (618) 624-0100

Interoperability endpoints

  • Direct secure messaging: nsuthan106199@ewd.direct.hshs.org

Organizations & group practices 8

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.

Hospital & facility affiliations 8

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": "1187395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1053504506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12860 TROXLER AVE",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622492898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12860 TROXLER AVE",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622492898",
            "telephone_number": "618-651-2810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Terminal Dr",
            "address_2": "Suite 8",
            "address_purpose": "LOCATION",
            "city": "East Alton",
            "state": "IL",
            "postal_code": "620242201",
            "country_code": "US",
            "telephone_number": "618-258-0485",
            "fax_number": "618-258-4815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTHAN",
        "first_name": "NANTHINI",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-18",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "059772",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036126643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEACHCARE FOR KIDS",
            "identifier": "448758879A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nsuthan106199@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "12860 Troxler Ave",
            "city": "Highland",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622492898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Highland, IL

Sources for this page

Verify at the official NPI Registry.