Mastan Rao Indlamuri, M.D.,

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036.142622 Issued in IL

Practice address

2239 E Cook St
Springfield, IL 62703-1944

Phone

(713) 500-7616

Fax

(713) 500-7619

NPI assigned

Jul 22, 2013

Last updated

Feb 12, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

Other, 2005

Medicare assignment

May accept Medicare assignment

Group practices

Central Counties Health Centers, Inc.Group PAC ID 3274445762, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Illinois Hospital and Clinics Hospital, Chicago, IL, CCN 140150
• St Johns Hospital Hospital, Springfield, IL, CCN 140053

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BBFICA
• Direct secure messaging: mastanrao.indlamuri@cchci.eclinicaldirectplus.com

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.

• Central Counties Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Springfield, IL
  • NPI 1861480709

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Central Counties Health Centers, Inc.

  dba Noll Dental Clinic

  • Federally Qualified Health Center (FQHC)
  • Springfield, IL
  • NPI 1861911893
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Johns Hospital of the Hospital Sisters of the Third Order of St F

  dba HSHS St. John's Hospital

  • General Acute Care Hospital
  • Springfield, IL
  • NPI 1205818481
  Care Compare affiliation
• The Board of Trustees of the University of Illinois

  dba University of Illinois Hospital and Clinics

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1861431751
  Care Compare affiliation

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1134561913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2239 E COOK ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627031944",
            "telephone_number": "217-788-2300",
            "fax_number": "217-788-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2239 E COOK ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627031944",
            "telephone_number": "713-500-7616",
            "fax_number": "713-500-7619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INDLAMURI",
        "first_name": "MASTAN RAO",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-22",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.142622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036142622",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Inabnit, M.D.
• Francesco Incandela
• Independence Holding Co LLC (Complete Care Pharmacy Downtown)
• Independence Holding Co LLC (Complete Care Pharmacy Downtown)
• Aishwarya Indiramohan, DDS
• Infinity-Meds LLP
• Ingalls Dialysis Center
• Laura Beth Ingalsbe, RN
• Dordana Elizabeth Ingram, LCSW
• Kathryn Ingram, BCBA

• Family Medicine Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.