Individual provider Active NPI

Samridhi Gulati, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Rockford, IL
National Provider Identifier
1245737253
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
036.167746 Issued in IL
Practice address
1340 Charles St Ste 401
Rockford, IL 61104-2200
Phone
(779) 696-6102
NPI assigned
Apr 7, 2018
Last updated
Oct 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 036.167746 IL Primary
Pulmonary Disease Physician 207RP1001X 036167746 IL

Addresses

Primary practice location

1340 Charles St Ste 401
Rockford, IL 61104-2200

Mailing address

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone (602) 344-5011

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
I20240925000737 IL Practitioner - Critical Care (Intensivists) 2961805569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

1401 E State St
Rockford, IL 61104-2315
Phone (815) 489-4400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.51 of 100Reported as group
Quality
83.2
Promoting interoperability
77
Improvement activities
40
Cost
71.7

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.167746ILMDCritical Care Medicine (Internal Medicine) Physician
036167746ILMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedishamerican Hospital CurrentSince Aug 6, 2024 Accepting new patients
Swedishamerican Hospital CurrentSince Aug 6, 2024 Accepting new patients
Swedishamerican Hospital Pulmonary Disease Current Accepting new patients

Locations

1340 Charles St
Ste 401
Rockford, IL 61104
Phone (779) 696-6102

1401 E State St
Rockford, IL 61104
Phone (815) 489-4267

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

Organizations & group practices 3

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 2

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": "1523059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1245737253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973",
            "telephone_number": "602-344-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 CHARLES ST STE 401",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042200",
            "telephone_number": "779-696-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULATI",
        "first_name": "SAMRIDHI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-07",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036.167746",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036167746",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.