Individual provider Active NPI

Osama Aaflaq, M.D.

  • Emergency Medicine Physician
  • Carbondale, IL
National Provider Identifier
1083663520
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036-089155 Issued in IL
Practice address
405 W Jackson St
Carbondale, IL 62901-1462
Phone
(618) 549-0721
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036-089155 IL Primary

Addresses

Primary practice location

405 W Jackson St
Carbondale, IL 62901-1462

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 549-0721

Other practice location 1

2808 Outer Dr
Marion, IL 62959-5207
Phone (618) 993-3817

Other identifiers 2

IdentifierTypeStateIssuer
036089155MedicaidIL
3932056OtherILBLUE SHIELD

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address oaaflaq13344@sih.direct-ci.com
Direct Messaging Address oaaflaq13344@sih.direct-ci.com

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
I20060509000326 IL Practitioner - Emergency MedicinePractitioner - Internal Medicine 8527079383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Illinois Medical Services NFPGroup PAC ID 3678677390, 331 clinicians

Practice addresses (Care Compare)

2601 W Main St
Carbondale, IL 62901-1031
Phone (618) 549-5361

Hospital & facility affiliations

  • Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
55.9
Promoting interoperability
100
Improvement activities
40
Cost
72.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-089155ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Medical Services, NFP CurrentSince Sep 2, 2008 Accepting new patients
Southern Illinois Gi Specialists LLC Past Accepting new patients

Locations

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

405 W Jackson St
Carbondale, IL 62901

2808 Outer Dr
Marion, IL 62959
Phone (618) 993-3817

2 S Hospital Dr
Murphysboro, IL 62966
Phone (618) 684-3156

Interoperability endpoints

  • Direct secure messaging: oaaflaq13344@sih.direct-ci.com
  • FHIR API: https://fa120b5c-6699-49eb-9b43-fa51a183b3cb.gastro.prod.fhir.ema-api.com/fhir/r4/

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.

Hospital & facility affiliations 1

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1083663520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-549-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W JACKSON ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011462",
            "telephone_number": "618-549-0721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2808 Outer Dr",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IL",
            "postal_code": "629595207",
            "country_code": "US",
            "telephone_number": "618-993-3817",
            "fax_number": "618-993-3908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AAFLAQ",
        "first_name": "OSAMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-089155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036089155",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "3932056",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oaaflaq13344@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "405 W Jackson St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oaaflaq13344@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2808 Outer Dr",
            "city": "Marion",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629595207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.