NPIMap

Individual provider Active NPI

Sunil N Matiwala, M.D.

  • Internal Medicine Physician
  • Bloomingdale, IL
National Provider Identifier
1174555601
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036118604 Issued in IL
Practice address
303 E Army Trail Rd
Suite 301
Bloomingdale, IL 60108-2169
Phone
(630) 893-0347
Fax
(630) 893-1467
NPI assigned
Jul 7, 2006
Last updated
Mar 25, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036118604 IL Primary

Addresses

Primary practice location

303 E Army Trail Rd
Suite 301
Bloomingdale, IL 60108-2169

Mailing address

PO Box 6365
Bloomingdale, IL 60108-6365
Phone (630) 893-0347

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
I20070730000016 IL Practitioner - Internal Medicine 0446355457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Adult Healthcare SCGroup PAC ID 2769546555, 2 clinicians

Practice addresses (Care Compare)

303 E Army Trail Rd
Suite 301
Bloomingdale, IL 60108-2152
Phone (630) 893-0347

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036118604ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Adult Healthcare SC Internal Medicine CurrentSince Jan 1, 2009 Accepting new patients
Mandeep S Kohli DO SC Internal Medicine Past Accepting new patients
Bonaventure Medical Foundation, LLC PastSince Jan 1, 2009 Accepting new patients
Emerson Hospital Past Accepting new patients

Locations

303 E Army Trail Rd
Ste 131
Bloomingdale, IL 60108
Phone (630) 532-8999

303 E Army Trail Rd
Ste 301
Bloomingdale, IL 60108
Phone (630) 582-2800

701 Winthrop Ave
Glendale Hts, IL 60139
Phone (630) 312-2000

675 S Roselle Rd
Schaumburg, IL 60193
Phone (847) 352-5500

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DDIGBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/DDIGBA/Endpoint/DDIGBA

Organizations & group practices 4

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 8

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427241600000",
    "number": "1174555601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6365",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601086365",
            "telephone_number": "630-893-0347",
            "fax_number": "630-893-1467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E ARMY TRAIL RD",
            "address_2": "SUITE 301",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082169",
            "telephone_number": "630-893-0347",
            "fax_number": "630-893-1467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATIWALA",
        "first_name": "SUNIL",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2015-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036118604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

Verify at the official NPI Registry.