NPIMap

Individual provider Active NPI

Sandhya Rani Grandhi

  • Family Medicine Physician
  • Carbondale, IL
National Provider Identifier
1093975419
Registry record updated Feb 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036125834 Issued in IL
Practice address
2601 W Main St
Carbondale, IL 62901-1031
Phone
(618) 549-5361
Fax
(618) 457-4542
NPI assigned
Jun 10, 2008
Last updated
Feb 18, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036125834 IL Primary

Addresses

Primary practice location

2601 W Main St
Carbondale, IL 62901-1031

Mailing address

1239 E Main St
P O Box 3988
Carbondale, IL 62901-3114
Phone (618) 457-5200

Other identifiers 2

IdentifierTypeStateIssuer
036125834MedicaidIL
00022MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101116000894 IL Practitioner - Family Practice 4789879768 Reassigns benefits to 5 organizations
I20210805000484 MO Practitioner - Family Practice 4789879768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Physicians of Illinois LLCGroup PAC ID 1557533734, 193 clinicians
Midwest Inpatient Anderson Health IncGroup PAC ID 3072908474, 46 clinicians

Practice addresses (Care Compare)

12303 De Paul Dr
Bridgeton, MO 63044-2512
Phone (314) 344-6000

400 N Caldwell St
Staunton, IL 62088-1173
Phone (618) 635-2200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Macoupin Physician Services, PC CurrentSince Feb 22, 2022 Accepting new patients
Altea Medical Illinois PLLC CurrentSince Mar 25, 2024 Accepting new patients
Midwest Emergency Anderson Health, Inc CurrentSince Feb 1, 2022 Accepting new patients
Post Acute Medical PLLC CurrentSince Mar 25, 2024 Accepting new patients
Midwest Inpatient Anderson Health, Inc CurrentSince Feb 1, 2022 Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

20733 N Broad St
Carlinville, IL 62626
Phone (217) 854-3141

490 W 16th Pl
Chicago Hts, IL 60411
Phone (708) 481-4444

3354 Jerome Ln
East Saint Louis, IL 62206
Phone (618) 337-9400

1101 E State St
Geneva, IL 60134
Phone (630) 232-7544

900 W River Pl
Kankakee, IL 60901
Phone (815) 933-1711

6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095

555 W Carpenter St
Springfield, IL 62702
Phone (217) 525-1880

400 N Caldwell St
Staunton, IL 62088
Phone (618) 635-2200

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297987200000",
    "number": "1093975419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 E MAIN ST",
            "address_2": "P O BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013114",
            "telephone_number": "618-457-5200",
            "fax_number": "618-351-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 W MAIN ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011031",
            "telephone_number": "618-549-5361",
            "fax_number": "618-457-4542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDHI",
        "first_name": "SANDHYA",
        "middle_name": "RANI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2011-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036125834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036125834",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00022",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.