Individual provider Active NPI

Richard Russell Symanski, D.O.

  • Diagnostic Radiology Physician
  • Morris, IL
National Provider Identifier
1255508768
Registry record updated Mar 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036120718 Issued in IL
Practice address
150 W High St
Morris, IL 60450-1463
Phone
(800) 379-8731
NPI assigned
May 14, 2008
Last updated
Mar 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036120718 IL Primary

Addresses

Primary practice location

150 W High St
Morris, IL 60450-1463

Mailing address

39798 Treasury Ctr
Chicago, IL 60694-9700
Phone (800) 379-8731

Other identifiers 1

IdentifierTypeStateIssuer
036120718MedicaidIL

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
I20091117000123 IL Practitioner - Diagnostic Radiology 4385782192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Chicago College of Osteopathy, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grundy Radiologists IncGroup PAC ID 2961597901, 5 clinicians

Practice addresses (Care Compare)

150 W High St
Morris, IL 60450-1463
Phone (815) 942-2932

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036120718ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grundy Radiologists Inc Diagnostic Radiology CurrentSince Aug 24, 2009 Accepting new patients

Locations

39798 Treasury Ctr
Chicago, IL 60694

150 W High St
Morris, IL 60450
Phone (815) 942-2129

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 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": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1255508768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39798 TREASURY CTR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606949700",
            "telephone_number": "800-379-8731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W HIGH ST",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604501463",
            "telephone_number": "800-379-8731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYMANSKI",
        "first_name": "RICHARD",
        "middle_name": "RUSSELL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-14",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036120718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036120718",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morris, IL

Sources for this page

Verify at the official NPI Registry.