NPIMap

Individual provider Active NPI

Pooria Javadi, M.D.

  • Diagnostic Radiology Physician
  • Normal, IL
National Provider Identifier
1114169893
Registry record updated Feb 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
36.141476 Issued in IL
Practice address
2200 Fort Jesse Rd
Ste 280
Normal, IL 61761-6286
Phone
(309) 452-1788
Fax
(309) 862-1302
NPI assigned
Mar 27, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35.125697 OH
Diagnostic Radiology Physician 2085R0202X 36.141476 IL Primary

Addresses

Primary practice location

2200 Fort Jesse Rd
Ste 280
Normal, IL 61761-6286

Mailing address

2200 Fort Jesse Rd
Ste 280
Normal, IL 61761-6286
Phone (309) 452-1788

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161021001276 IL Practitioner - Diagnostic Radiology 2961713623 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Wisconsin, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians
Carle West Physician Group IncGroup PAC ID 8921420308, 282 clinicians

Practice addresses (Care Compare)

101 S Major St
Eureka, IL 61530-1246
Phone (309) 304-2128

2204 Eastland Dr
Bloomington, IL 61704-3567
Phone (309) 663-0222

3024 E Empire St
Bloomington, IL 61704-5402

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

911 S Chestnut St
Le Roy, IL 61752-1894
Phone (309) 962-2035

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36.141476ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Care Incorporated CurrentSince Oct 4, 2025 Accepting new patients
Richland Memorial Hospital, Inc Current Accepting new patients
Carle West Physician Group Inc CurrentSince May 8, 2023 Accepting new patients
Carle Eureka Hospital CurrentSince Jan 31, 2026 Accepting new patients
Richland Memorial Hospital, Inc CurrentSince Jun 21, 2023 Accepting new patients
Richland Memorial Hospital, Inc CurrentSince Jun 21, 2023 Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

2200 Fort Jesse Rd
Ste 280
Normal, IL 61761
Phone (800) 755-9195

900 E Scott St
Olney, IL 62450
Phone (618) 345-1000

1201 Ricker Rd
Salem, IL 62881
Phone (618) 548-3194

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1114169893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 FORT JESSE RD",
            "address_2": "STE 280",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616286",
            "telephone_number": "309-452-1788",
            "fax_number": "309-862-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 FORT JESSE RD",
            "address_2": "STE 280",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616286",
            "telephone_number": "309-452-1788",
            "fax_number": "309-862-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVADI",
        "first_name": "POORIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-27",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.125697",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "36.141476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

Verify at the official NPI Registry.