Individual provider Active NPI

Momen Abbasi, M.D.

  • Nephrology Physician
  • Chicago, IL
National Provider Identifier
1184472268
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
125.083087 Issued in IL
Practice address
820 S. Wood Street
University of Illinois Chicago Division of Nephrology M
Chicago, IL 60612
Phone
(312) 996-6736
Fax
(312) 996-7378
NPI assigned
May 13, 2024
Last updated
Aug 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 125.083087 IL Primary

Addresses

Primary practice location

820 S. Wood Street
University of Illinois Chicago Division of Nephrology M
Chicago, IL 60612

Mailing address

820 S. Wood Street
University of Illinois Chicago Division of Nephrology M
Chicago, IL 60612
Phone (312) 996-6736

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
I20240820002751 IL Order and Referring Only - NephrologyPractitioner - Nephrology 8527506674

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7732 Solution Ctr
Chicago, IL 60677

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: mabbasi172071@uihealth.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1184472268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S. WOOD STREET",
            "address_2": "UNIVERSITY OF ILLINOIS CHICAGO DIVISION OF NEPHROLOGY M",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-996-6736",
            "fax_number": "312-996-7378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S. WOOD STREET",
            "address_2": "UNIVERSITY OF ILLINOIS CHICAGO DIVISION OF NEPHROLOGY M",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-996-6736",
            "fax_number": "312-996-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBASI",
        "first_name": "MOMEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "125.083087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.