Alhang Sanyo Konyak, MD
Individual provider Active NPI Family Medicine Physician · Indianapolis, IN
NPI 1225266992 · NPPES record last updated Jun 24, 2024
Key facts
- NPI
- 1225266992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 01092581A (IN)
- Practice address
- 8414 Naab Rd
Indianapolis, IN 46260-1972 - Phone
- (317) 338-7510
- NPI assigned
- Jul 1, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Vincent Physician Services Hospital and Health Care Center
Practice addresses (Care Compare)
8414 Naab Rd
Indianapolis, IN 46260-1972
Phone (317) 338-7510
Hospital & facility affiliations
- Ascension St Vincent Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL, IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170804001897 | IL | Practitioner - Family Practice | 4082897012 | Reassigns benefits to 3 organizations |
| I20240405002530 | IN | Practitioner - Family Practice | 4082897012 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036142978 | IL | MD | Family Medicine Physician |
| 01092581A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Board of Trustees of the University of Illinois | Family Medicine | Current |
Accepting new patients |
| Freeport Regional Health Care Foundation | Family Medicine | Current |
Accepting new patients |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current |
Accepting new patients | |
| St Vincent Physician Services Hospital and Health Care Center | Current |
Accepting new patients | |
| Rockford Health Physicians | Current |
Accepting new patients | |
| St Vincent Physician Services Hospital and Health Care Center | Family Medicine | Current |
Accepting new patients |
| Ahs Oklahoma Physician Group LLC | Family Medicine | Past | Accepting new patients |
| Saint Vincent Physician Services, Inc. | Family Medicine | Past | Accepting new patients |
Locations
7736 Solution Ctr
Chicago, IL 60677
29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652
1010 Fairway Dr
Freeport, IL 61032
Phone (815) 599-6340
1045 W Stephenson St
Freeport, IL 61032
Phone (815) 599-6105
2350 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-2200
2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510
1221 E State St
Rockford, IL 61104
Phone (815) 972-1000
1511 N Blackhawk Blvd
Rockton, IL 61072
Phone (815) 395-5879
600 N Rush St
Stockton, IL 61085
Phone (815) 235-3165
250 W 96th St
Ste 520
Indianapolis, IN 46260
Phone (317) 583-3211
8240 Naab Rd
Ste 155
Indianapolis, IN 46260
Phone (317) 338-7760
8414 Naab Rd
Indianapolis, IN 46260
Phone (317) 338-1600
Interoperability endpoints
- alhang.konyak.1@7598.direct.athenahealth.com
- https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036142978 | IL | |
| Family Medicine Physician | 207Q00000X | 01092581A | IN | Yes |
Addresses
Primary practice location
8414 Naab Rd
Indianapolis, IN 46260-1972
Mailing address
8414 Naab Rd
Indianapolis, IN 46260-1972
Other practice location 1
2300 N Rockton Ave
Rockford, IL 61103-3619
Phone (815) 971-2000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036142978 | Other | IL | IL PHYSICIAN LICENSE |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | alhang.konyak.1@7598.direct.athenahealth.com | ST VINCENT PHYSICIAN SERVICES HOSPITAL AND HEALTH CARE CENTER |
Other providers in Indianapolis, IN
- Amy D Konkle
- Robert John Konrad
- Jeffrey Allen Kons
- Kali Konstantinopoulos
- Jennifer Kontos
- Anna Liese Kooi
- Banks Walter Kooken
- Maria Gulas Kooken
- Richard Paul Koomler
- Makenzie Koon
All providers in Indianapolis, IN · Family Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.