NPIMap

Individual provider Active NPI

Michael Darmadi, MD

  • Internal Medicine Physician
  • Vandalia, IL
National Provider Identifier
1184601577
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036097600 Issued in IL
Practice address
1003 N 8TH St
Vandalia, IL 62471-1238
Phone
(618) 283-4445
Fax
(618) 283-4446
NPI assigned
Dec 27, 2005
Last updated
Jun 16, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036097600 IL Primary
Pediatrics Physician 208000000X 036097600 IL

Addresses

Primary practice location

1003 N 8TH St
Vandalia, IL 62471-1238

Mailing address

1003 N 8TH St
Vandalia, IL 62471-1238
Phone (618) 283-4445

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
I20080611000358 IL Practitioner - Internal MedicinePractitioner - Pediatric Medicine 1951472489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Saint Louis University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1003 N 8TH St
Vandalia, IL 62471-1238
Phone (618) 283-4445

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
22.02 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
73.4

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as apm
Quality
69.5
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036097600ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaskaskia Medical Center, LTD Internal Medicine CurrentSince Jun 4, 2008 Accepting new patients

Locations

100 N 8TH St
Vandalia, IL 62471

1003 N 8th St
Vandalia, IL 62471
Phone (618) 283-4445

Organizations & group practices 1

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 9

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": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1184601577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 N 8TH ST",
            "city": "VANDALIA",
            "state": "IL",
            "postal_code": "624711238",
            "telephone_number": "618-283-4445",
            "fax_number": "618-283-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 N 8TH ST",
            "city": "VANDALIA",
            "state": "IL",
            "postal_code": "624711238",
            "telephone_number": "618-283-4445",
            "fax_number": "618-283-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARMADI",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036097600",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036097600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vandalia, IL

Sources for this page

Verify at the official NPI Registry.