Individual provider Active NPI

Colin W. Sumida, M.D.

  • Cardiovascular Disease Physician
  • New Lenox, IL
National Provider Identifier
1174572119
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036065985 Issued in IL
Practice address
1890 Silver Cross Blvd Ste 240
New Lenox, IL 60451-9528
Phone
(815) 740-1900
Fax
(815) 485-4463
NPI assigned
May 8, 2006
Last updated
Feb 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 036065985 IL
Cardiovascular Disease Physician 207RC0000X 036065985 IL Primary

Addresses

Primary practice location

1890 Silver Cross Blvd Ste 240
New Lenox, IL 60451-9528

Mailing address

1860 Paysphere Cir
Chicago, IL 60674-0018
Phone (630) 469-9200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address csumida131851@direct.edward.org

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040413000187 IL Practitioner - Cardiovascular Disease (Cardiology) 8921910100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Northwestern University Feinberg Medical School, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

1325 N Meacham Rd
Schaumburg, IL 60173-4824
Phone (630) 469-9200

17495 La Grange Rd
Tinley Park, IL 60487-7581
Phone (708) 226-7000

1890 Silver Cross Blvd
Suite 345
New Lenox, IL 60451-9606
Phone (815) 462-9300

2100 Glenwood Ave
Joliet, IL 60435-5487
Phone (815) 725-2121

30 Stratford Dr
Bloomingdale, IL 60108-2201
Phone (630) 893-2210

301 Madison St
Joliet, IL 60435-6654

330 Madison St
L14
Joliet, IL 60435-6565
Phone (815) 725-2121

40 S Clay St
Hinsdale, IL 60521-3257

430 Pennsylvania Ave
Glen Ellyn, IL 60137-4464
Phone (630) 469-9200

430 Warrenville Rd
Suite 210
Lisle, IL 60532-1348
Phone (630) 432-6180

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal28

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036065985ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Nov 1, 2016 Accepting new patients
Dupage Medical Group LTD CurrentSince Nov 1, 2016 Accepting new patients
Loyola University Physician Foundation Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

1200 Maple Rd
Ste 3030
Joliet, IL 60432
Phone 81574019006214

301 Madison St
Ste 207
Joliet, IL 60435

301 Madison St
Ste 275
Joliet, IL 60435

333 Madison St
Joliet, IL 60435
Phone (815) 725-7222

1890 Silver Cross Blvd
New Lenox, IL 60451
Phone (815) 300-2802

1890 Silver Cross Blvd
Ste 240
New Lenox, IL 60451
Phone (815) 485-4469

Interoperability endpoints

  • Direct secure messaging: csumida131851@direct.edward.org
  • Direct secure messaging: csumida131851@dulyhealthandcare.direct-ci.com

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 6

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1174572119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740018",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 SILVER CROSS BLVD STE 240",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519528",
            "telephone_number": "815-740-1900",
            "fax_number": "815-485-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMIDA",
        "first_name": "COLIN",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036065985",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036065985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csumida131851@direct.edward.org",
            "affiliation": "N",
            "address_1": "1890 Silver Cross Blvd Ste 240",
            "city": "New Lenox",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604519528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

Verify at the official NPI Registry.