Individual provider Active NPI

Miranda Sirvinskas, NP

  • Nurse Practitioner
  • Bourbonnais, IL
National Provider Identifier
1083336861
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209026149 Issued in IL
Practice address
400 Riverside Dr Ste 2100
Bourbonnais, IL 60914-5004
Phone
(815) 935-2784
NPI assigned
Sep 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209026149 IL Primary

Addresses

Primary practice location

400 Riverside Dr Ste 2100
Bourbonnais, IL 60914-5004

Mailing address

400 Riverside Dr Ste 2100
Bourbonnais, IL 60914-5004
Phone (815) 935-2784

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230213000662 IL Practitioner - Nurse Practitioner 1153793534 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
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)

105 S 1St St
Willmington, IL 60481-8973
Phone (815) 476-5210

400 Riverside Dr
Suite 2800
Bourbonnais, IL 60914-5004
Phone (815) 935-1100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209026149ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Express Care 2, Inc CurrentSince Dec 19, 2022 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Dec 19, 2022 Accepting new patients
Riverside Health System CurrentSince Nov 20, 2023 Accepting new patients
Riverside Health System Current Accepting new patients

Locations

300 Riverside Dr
Ste 2100
Bourbonnais, IL 60914
Phone (815) 928-9666

400 Riverside Dr
Ste 2100
Bourbonnais, IL 60914
Phone (815) 935-2784

2070 N State Route 50
Ste 500
Bourbonnais, IL 60914
Phone (779) 236-4094

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

Interoperability endpoints

  • Direct secure messaging: msirvinska47123@direct.riversidehealthcare.net

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 2

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": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1083336861",
    "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRVINSKAS",
        "first_name": "MIRANDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-19",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209026149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

Verify at the official NPI Registry.