Active NPI
Eliathamby Kuganeswaran, M.D.
- Gastroenterology Physician
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 036105345
- Practice address
- 1001 W Main St
Suite 500a
Peoria, IL 61606-1276 - Phone
- (309) 672-4980
- Fax
- (309) 671-2944
- NPI assigned
- Jun 11, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 036105345 | IL | Primary |
Addresses
Primary practice location
1001 W Main St
Suite 500a
Peoria, IL 61606-1276
Mailing address
PO Box 365
Morton, IL 61550-0365
Phone (309) 672-4980
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036105345 | Medicaid | IL | |
| 100015542 | Other | IL | RAILROAD MEDICARE |
| 071696 | Other | IL | HEALTH ALLIANCE |
| 371221637 | Other | IL | FEDERAL TAX IDENTIFICATIO |
| 658303 | Other | IL | HEALTHLINK |
| 07215152 | Other | IL | BLUE CROSS |
| 776530 | Other | IL | MEDICARE GROUP NUMBER |
| 7991429 | Other | IL | AETNA HEALTH PLANS |
| IL0117 | Other | IL | JOHN DEERE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Other, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1001 Main St
Suite 500a
Peoria, IL 61606-2038
Phone (309) 672-4980
221 NE Glen Oak
Peoria, IL 61636-0001
Phone (309) 672-5522
221 NE Glen Oak Ave
Peoria, IL 61636-0001
611 W Park St
Urbana, IL 61801-2500
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
815 Main St
Peoria, IL 61602-1076
Phone (309) 672-4977
815 Main St
Suite a
Peoria, IL 61602-1080
Phone (309) 672-4977
Hospital & facility affiliations
- Carle Health Methodist Hospital
- Carle Health Pekin Hospital
- Carle Health Proctor Hospital
- Saint Francis Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.21 of 100
- Quality
- 67.65
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 80.55
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 158 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 125 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elgin Gastroenterology SC | Gastroenterology | Current | Accepting new patients |
| Northwest Gastroenterologists SC | Current | Accepting new patients | |
| Elgin Gastroenterology Endoscopy Center LLC | Current | Accepting new patients | |
| Pekin Prohealth Inc | Current | Accepting new patients | |
| Methodist Medical Center of Illinois | Current | Accepting new patients | |
| Carle Health Care Incorporated | Gastroenterology | Current | Accepting new patients |
| Methodist Medical Center of Illinois | Current | Accepting new patients | |
| Illinois Gastroenterology Group, LLC | Gastroenterology | Current | Accepting new patients |
| Central Illinois Endoscopy Center, LLC | Past | Accepting new patients |
Locations
745 Fletcher Dr
Ste 202
Elgin, IL 60123
Phone (855) 483-7362
101 S Major St
Eureka, IL 61530
Phone (309) 268-2172
2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246
600 S 13th St
#J
Pekin, IL 61554
Phone (309) 353-0607
600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151
1001 Main St
Ste 500B
Peoria, IL 61606
Phone (309) 495-1144
221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281
1001 Main St
Ste 500A
Peoria, IL 61606
Phone (309) 672-4980
815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986
815 Main St
Ste A1
Peoria, IL 61602
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Organizations & group practices 9
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.
-
- Internal Medicine Physician
- Urbana, IL
- NPI 1154653947
Gastroenterology
-
- Rehabilitation Hospital Unit
- Peoria, IL
- NPI 1982656575
-
- Gastroenterology Physician
- Elgin, IL
- NPI 1316277817
-
- Family Medicine Physician
- Pekin, IL
- NPI 1932150299
-
- Ambulatory Surgical Clinic/Center
- Elgin, IL
- NPI 1992875454
-
- Gastroenterology Physician
- Elgin, IL
- NPI 1932291101
-
- General Acute Care Hospital
- Peoria, IL
- NPI 1164474755
-
- Specialist
- Arlington Heights, IL
- NPI 1801886221
-
- Endoscopy Clinic/Center
- Peoria, IL
- NPI 1790924306
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Peoria, IL
- NPI 1164474755
-
- General Acute Care Hospital
- Pekin, IL
- NPI 1245227479
-
- General Acute Care Hospital
- Peoria, IL
- NPI 1033116876
-
- Rehabilitation Hospital Unit
- Peoria, IL
- NPI 1134826894
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243468800000",
"number": "1073555488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 365",
"city": "MORTON",
"state": "IL",
"postal_code": "615500365",
"telephone_number": "309-672-4980",
"fax_number": "309-671-2944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 W MAIN ST",
"address_2": "SUITE 500A",
"city": "PEORIA",
"state": "IL",
"postal_code": "616061276",
"telephone_number": "309-672-4980",
"fax_number": "309-671-2944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUGANESWARAN",
"first_name": "ELIATHAMBY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-11",
"last_updated": "2009-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "IL",
"license": "036105345",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036105345",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "100015542",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ALLIANCE",
"identifier": "071696",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL TAX IDENTIFICATIO",
"identifier": "371221637",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "658303",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "07215152",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP NUMBER",
"identifier": "776530",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HEALTH PLANS",
"identifier": "7991429",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE",
"identifier": "IL0117",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; 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.