Individual provider Active NPI

Mohamad Fatin Atassi, MD

  • Cardiovascular Disease Physician
  • Chicago, IL
National Provider Identifier
1073508172
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036062020 Issued in IL
Practice address
6625 S Pulaski Rd
Chicago, IL 60629-5137
Phone
(773) 585-1555
Fax
(773) 585-1787
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036062020 IL Primary

Addresses

Primary practice location

6625 S Pulaski Rd
Chicago, IL 60629-5137

Mailing address

6625 S Pulaski Rd
Chicago, IL 60629-5137
Phone (773) 585-1555

Other identifiers 1

IdentifierTypeStateIssuer
036062020MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address matassi278961@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20050727000108 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3173551686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

9831 S Western
Chicago, IL 60643
Phone (773) 881-5232

Hospital & facility affiliations

  • Advocate Home Health Care Serv Home health agency, Oakbrook, IL, CCN 147150
  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208
  • Advocate Trinity Hospital Hospital, Chicago, IL, CCN 140048

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036062020ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Sep 14, 2020 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Sep 14, 2020 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Vivek Gupta, M.D., S.C. Past Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

9831 S Western Ave
Chicago, IL 60643
Phone (773) 445-3500

6625 S Pulaski Rd
Chicago, IL 60629
Phone (312) 585-1555

29373 Network Pl
Chicago, IL 60673

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1073508172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 S PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295137",
            "telephone_number": "773-585-1555",
            "fax_number": "773-585-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 S PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295137",
            "telephone_number": "773-585-1555",
            "fax_number": "773-585-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATASSI",
        "first_name": "MOHAMAD",
        "middle_name": "FATIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036062020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036062020",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matassi278961@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6625 S Pulaski Rd",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606295137",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "6625 S Pulaski Rd",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606295137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.