Kamal Kishore, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036-100858 Issued in IL

Practice address

3602 Marquette Rd
Peru, IL 61354-1450

Phone

(815) 223-7400

NPI assigned

Apr 4, 2007

Last updated

Jun 2, 2014By 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

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

Ophthalmology

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Illinois Retina Institute, SCGroup PAC ID 0941398077, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013
• CGH Medical Center Hospital, Sterling, IL, CCN 140043
• St Mary Medical Center Hospital, Galesburg, IL, CCN 140064
• Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Illinois Retina Institute, SC

  • Ophthalmology Physician
  • Peru, IL
  • NPI 1003875436
  Medicare reassignment Care Compare group NPD Authorized official
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Bond Eye Associates, S.C.

  • Optician
  • Canton, IL
  • NPI 1104025485
  NPD (past)
• Bond Eye Associates, SC

  • Ophthalmology Physician
  • Pekin, IL
  • NPI 1285725903
  NPD (past)
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681

  Ophthalmology

  NPD (past)
• The Vein Specialists, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bloomington, IL
  • NPI 1861703100
  NPD (past)

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

• CGH Medical Center

  • General Acute Care Hospital
  • Sterling, IL
  • NPI 1902854623
  Care Compare affiliation
• Ottawa Regional Hospital & Healthcare Center

  dba OSF Saint Elizabeth Medical Center

  • General Acute Care Hospital
  • Peru, IL
  • NPI 1588713440
  Care Compare affiliation
• Proctor Community Hospital

  dba Proctor Hospital

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1033116876
  Care Compare affiliation
• Proctor Community Hospital

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1134826894
  Care Compare affiliation
• St Mary Medical Center

  dba OSF Saint Mary Medical Center

  • General Acute Care Hospital
  • Galesburg, IL
  • NPI 1164485363
  Care Compare affiliation

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401667200000",
    "number": "1215059977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616500036",
            "telephone_number": "815-223-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3602 MARQUETTE RD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541450",
            "telephone_number": "815-223-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISHORE",
        "first_name": "KAMAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2014-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036-100858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patcharaporn Keane, PHARMD
• Tara Ketner, RDN, LDN
• Alison Jeanne Kibilka, CRNA
• Won Yang Kim, M.D.
• Robert S Kinsella, D.O.
• Gary Joseph Kistenfeger, PT
• Pamela M Koehler, CNM
• Christine Kohut, LCSW
• Robert James Koogler, M.D.
• Steve Korsan, MS, ATC

• Ophthalmology Physician in Peru, IL
• Providers in Peru, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; 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.