Active NPI
Bissy Kumpuckal, NP
- Family Nurse Practitioner
- Darien, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209013257
- Practice address
- 2213 Hamilton LN
Darien, IL 60561-4346 - Phone
- (630) 689-6553
- NPI assigned
- Nov 5, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209013257 | IL | Primary |
Addresses
Primary practice location
2213 Hamilton LN
Darien, IL 60561-4346
Mailing address
1333 Butterfield Rd
Ste 130
Downers Grove, IL 60515-5641
Phone (630) 371-0133
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
27650 Ferry Rd
Warrenville, IL 60555-3845
Phone (630) 225-2663
Hospital & facility affiliations
- Northwestern Medicine Central Dupage Hospital
- Northwestern Medicine Delnor Community Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.63 of 100
- Quality
- 88.47
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Dupage Physician Group | Current | Accepting new patients | |
| Central Dupage Physician Group | Current | Accepting new patients |
Locations
Dept 5777
Carol Stream, IL 60122
27650 Ferry Rd
Ste 100
Warrenville, IL 60555
Phone (630) 225-2455
27650 Ferry Rd
Warrenville, IL 60555
Phone (630) 225-2345
1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045
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.
-
- Family Medicine Physician
- Carol Stream, IL
- NPI 1033149844
-
- Multi-Specialty Clinic/Center
- Carol Stream, IL
- NPI 1346235314
-
- Orthopaedic Surgery Physician
- Geneva, IL
- NPI 1780012344
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Winfield, IL
- NPI 1003864810
-
- Psychiatric Hospital Unit
- Winfield, IL
- NPI 1740230895
-
- General Acute Care Hospital
- Geneva, IL
- NPI 1407859655
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451952000000",
"number": "1053784645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1333 BUTTERFIELD RD",
"address_2": "STE 130",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605155641",
"telephone_number": "630-371-0133",
"fax_number": "630-371-0138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2213 HAMILTON LN",
"city": "DARIEN",
"state": "IL",
"postal_code": "605614346",
"telephone_number": "630-689-6553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUMPUCKAL",
"first_name": "BISSY",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-11-05",
"last_updated": "2016-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209013257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Darien, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.