NPIMap

Individual provider Active NPI

Rashid Ahmed Dalal, MD

  • Nephrology Physician
  • Fairview Heights, IL
National Provider Identifier
1265434815
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036090043 Issued in IL
Practice address
5003 N Illinois St Ste 1
Fairview Heights, IL 62208-3419
Phone
(618) 239-9500
Fax
(618) 239-9555
NPI assigned
Aug 12, 2005
Last updated
Apr 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD103192 MO
Nephrology Physician 207RN0300X 036090043 IL Primary

Addresses

Primary practice location

5003 N Illinois St Ste 1
Fairview Heights, IL 62208-3419

Mailing address

7 Beaver Creek CT
Saint Charles, MO 63303-5497
Phone (618) 239-9500

Other identifiers 10

IdentifierTypeStateIssuer
110483OtherBCBS CHOICE
203771902MedicaidMO
816M2OtherMOBCBS ALLIANCE
2369786OtherAETNA PRUDENTIAL
286639OtherHEALTHLINK PPO HMO WC
3100008 NEPHOtherUNITED HEALTHCARE
110184061OtherRR MEDICARE
8226186OtherILBCBS
38137OtherGHP SENSICARE ACCESS, CMR
036090043MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050627001179 IL Practitioner - NephrologyPractitioner - Internal Medicine 7315982691 Reassigns benefits to 2 organizations
I20111027000384 MO Practitioner - NephrologyPractitioner - Internal Medicine 7315982691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1985
Medicare assignment
May accept Medicare assignment
Group practices
Southern Illinois Healthcare Foundation IncGroup PAC ID 1456256874, shared by 35 NPIs, 117 clinicians
Rashid a Dalal MD PCGroup PAC ID 2163459348, 5 clinicians

Practice addresses (Care Compare)

2041 Goose Lake Rd
Sauget, IL 62206-2822

2071 Goose Lake Rd
Sauget, IL 62206-2822
Phone (618) 857-2700

2610 Clark Ave
Saint Louis, MO 63103-2502
Phone (314) 534-0909

5003 N Illinois St
Suite 1
Fairview Heights, IL 62208-3419

5105 W Main St
Belleville, IL 62226-4728
Phone (618) 239-9500

6420 Clayton Rd
Richmond Heights, MO 63117-1811
Phone (314) 768-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.85 of 100Reported as individual
Quality
71.18
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036090043ILMDNephrology Physician
MD103192MOMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Healthcare Foundation Inc Current Accepting new patients
Southern Illinois Healthcare Foundation, Inc. CurrentSince Jun 6, 2019 Accepting new patients
Southern Illinois Healthcare Foundation Inc CurrentSince Jun 6, 2019 Accepting new patients
Douglass T. Domoto, M.D., J.D., P.C. Nephrology PastSince Oct 7, 2010 Accepting new patients

Locations

211 S 3rd St
Belleville, IL 62220
Phone (618) 234-2700

5900 Bond Ave
East Saint Louis, IL 62207
Phone (618) 332-3060

2001 State St
East St Louis, IL 62205
Phone (618) 271-0204

2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000

2071 Goose Lake Rd
Sauget, IL 62206
Phone (314) 872-1473

Interoperability endpoints

  • Direct secure messaging: rashid.dalal.2@9559.direct.athenahealth.com
  • Direct secure messaging: rashid.dalal@direct.davitaphysiciansolutions.com
  • Direct secure messaging: rdalal@yourcarecommunity.org

Organizations & group practices 5

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1265434815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BEAVER CREEK CT",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633035497",
            "telephone_number": "618-239-9500",
            "fax_number": "618-239-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5003 N ILLINOIS ST STE 1",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622083419",
            "telephone_number": "618-239-9500",
            "fax_number": "618-239-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALAL",
        "first_name": "RASHID",
        "middle_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MO",
            "license": "MD103192",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036090043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS CHOICE",
            "identifier": "110483",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203771902",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ALLIANCE",
            "identifier": "816M2",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PRUDENTIAL",
            "identifier": "2369786",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK PPO HMO WC",
            "identifier": "286639",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "3100008 NEPH",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110184061",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8226186",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP SENSICARE ACCESS, CMR",
            "identifier": "38137",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036090043",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4550 Memorial Dr",
            "address_2": "Medical Bldg 1 Suite 360",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622265369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairview Heights, IL

Sources for this page

Verify at the official NPI Registry.