Brandon William Segrest, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036156993 Issued in IL

Practice address

700 E Ogden Ave Ste 202
Westmont, IL 60559-1296

Phone

(630) 528-3215

Fax

(630) 528-3219

NPI assigned

May 3, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Specialty

Internal Medicine

Education

West Virginia School of Osteopathic Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associates of Integrated Medicine LTDGroup PAC ID 3779876636, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uplifted Care Hospice, Bourbonnais, IL, CCN 141556
• Riverside Medical Center Hospital, Kankakee, IL, CCN 140186
• Presence St Marys Hospital Hospital, Kankakee, IL, CCN 140155
• Miller Health Care Center Nursing home, Kankakee, IL, CCN 145843

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Associates of Integrated Medicine LTD.

  • Internal Medicine Physician
  • Kankakee, IL
  • NPI 1427407345
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hospice of Kankakee Valley, Inc.

  • Community Based Hospice Care Agency
  • Bourbonnais, IL
  • NPI 1811935240
  Care Compare affiliation
• Riverside Medical Center

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1538208210
  Care Compare affiliation
• Riverside Senior Living Center

  • Skilled Nursing Facility
  • Kankakee, IL
  • NPI 1174603377

  Nursing home

  Care Compare affiliation
• St Marys Hospital - Kankakee LLC

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1467290809
  Care Compare affiliation

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

{
    "created_epoch": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1063901189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E OGDEN AVE STE 202",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591296",
            "telephone_number": "630-528-3215",
            "fax_number": "630-528-3219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E OGDEN AVE STE 202",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591296",
            "telephone_number": "630-528-3215",
            "fax_number": "630-528-3219"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11885 E 12 Mile Rd Ste 300A",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480933467",
            "country_code": "US",
            "telephone_number": "586-582-6330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEGREST",
        "first_name": "BRANDON",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-03",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036156993",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "1063901189",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036156993",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Furey Schultz, MD
• Khadija Janel Scott
• Whitney Scott, LPC - INTERN
• Cortney E Sears, LCSW
• Goma Sedai, NURSE PRACTITIONER
• John Paul Seisser II, PTA
• Paul Setlak, B.S., PHARM.D.
• Kathleen J Sexton-Radek, PHD
• Anjali Shah
• Jill Shah, DPT

• Internal Medicine Physician in Westmont, IL
• Providers in Westmont, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.

Verify at the official NPI Registry.