Individual provider Active NPI

Ernest Mensah, MD

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1104855253
Registry record updated Mar 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036100047 Issued in IL
Practice address
7531 S Stony Island Ave
Chicago, IL 60649-3954
Phone
(773) 947-7500
Fax
(773) 947-7792
NPI assigned
Jul 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2010

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 036100047 IL Primary

Addresses

Primary practice location

7531 S Stony Island Ave
Chicago, IL 60649-3954

Mailing address

6 Helens Way CT
Naperville, IL 60565-1107

Other identifiers 2

IdentifierTypeStateIssuer
036100047-4MedicaidIL
1104855253MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160329000870 FL Practitioner - Emergency Medicine 0749181303 Reassigns benefits to 2 organizations
I20180712001143 MI Practitioner - Emergency Medicine 0749181303 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Sound Physicians Emergency Medicine of Michigan, PLLC Emergency Medicine CurrentSince Jul 1, 2018 Accepting new patients
Paragon Emergency Services LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Southside Primary Care Group SC PastSince Feb 11, 2024 Accepting new patients
Rajiv Kandala M D S C PastSince Jun 27, 2021 Accepting new patients
Hospital & Medical Foundation of Paris, Inc. Past Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

8300 Red Bug Lake Rd
Oviedo, FL 32765
Phone (407) 359-6007

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

1401 W Seminole Blvd
Sanford, FL 32771
Phone (317) 805-2316

1451 El Camino Real
The Villages, FL 32159
Phone (352) 751-8000

1501 W Chisholm St
Alpena, MI 49707
Phone (989) 356-7000

420 W High St
Dowagiac, MI 49047
Phone (269) 782-8681

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267401600000",
    "number": "1104855253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HELENS WAY CT",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605651107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7531 S STONY ISLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493954",
            "telephone_number": "773-947-7500",
            "fax_number": "773-947-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENSAH",
        "first_name": "ERNEST",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2010-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036100047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100047-4",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104855253",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.