Nadeem Ansari, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036-071794 Issued in IL

Practice address

400 Riverside Dr Ste 2100
Bourbonnais, IL 60914-5004

Phone

(815) 935-2784

Fax

(815) 935-5687

NPI assigned

Feb 2, 2007

Last updated

Jan 11, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Riverside Health SystemGroup PAC ID 3274434717, 202 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• R.M.C. Home Health Care Home health agency, Peotone, IL, CCN 147400
• Prime Healthcare Home Care and Hospice, LLC Home health agency, Kankakee, IL, CCN 147105
• Uplifted Care Hospice, Bourbonnais, IL, CCN 141556
• Riverside Medical Center Hospital, Kankakee, IL, CCN 140186
• Presence St Marys Hospital Hospital, Kankakee, IL, CCN 140155

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nansari6685@direct.riversidehealthcare.net

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Riverside Medical Center

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1538208210

  Corporate Director

  CMS ownership
• Riverside Medical Center

  • Home Health Agency
  • Peotone, IL
  • NPI 1740346451

  Corporate Director

  CMS ownership
• Riverside Medical Center

  • Psychiatric Hospital Unit
  • Kankakee, IL
  • NPI 1982093837

  Corporate Director

  CMS ownership
• Riverside Medical Center

  dba Pembroke Community Health Center

  • Family Medicine Physician
  • Hopkins Park, IL
  • NPI 1982703005

  Corporate Director

  CMS ownership

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.

• Riverside Health System

  • General Practice Physician
  • Kankakee, IL
  • NPI 1417061193
  Medicare reassignment Care Compare group NPD
• Riverside Health System

  dba Psychiatric Associates

  • Psychiatry Physician
  • Kankakee, IL
  • NPI 1336354430
  NPD
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)
• Riverside Medical Center

  • Home Health Agency
  • Peotone, IL
  • NPI 1740346451
  NPD (past)

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
• Presence Home Care

  dba Presence Home Care - Kankakee

  • Home Health Agency
  • Kankakee, IL
  • NPI 1134178338
  Care Compare affiliation
• Riverside Medical Center

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

  • Home Health Agency
  • Peotone, IL
  • NPI 1740346451
  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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1073651808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RIVERSIDE DR STE 2100",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609145004",
            "telephone_number": "815-935-2784",
            "fax_number": "815-935-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 RIVERSIDE DR STE 2100",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609145004",
            "telephone_number": "815-935-2784",
            "fax_number": "815-935-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSARI",
        "first_name": "NADEEM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-071794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036071794",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nansari6685@Direct.riversidehealthcare.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "400 Riverside Dr Ste 2100",
            "city": "Bourbonnais",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609145004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Internal Medicine Physician in Bourbonnais, IL
• Providers in Bourbonnais, 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 Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.