Individual provider Active NPI

Adarsh Bairsetty, MD

  • Family Medicine Physician
  • Decatur, IL
National Provider Identifier
1285856278
Registry record updated Aug 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036122575 Issued in IL
Practice address
550 Southland Dr
Suite 1
Decatur, IL 62521-4080
Phone
(217) 422-0311
Fax
(217) 422-0416
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036122575 IL Primary

Addresses

Primary practice location

550 Southland Dr
Suite 1
Decatur, IL 62521-4080

Mailing address

550 Southland Dr
Suite 1
Decatur, IL 62521-4080
Phone (217) 422-0311

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
I20091118000165 IL Practitioner - Family Practice 4183762867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

1505 Eastland Dr
Bloomington, IL 61701-3534
Phone (309) 662-5506

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Oct 10, 2016 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

1505 Eastland Dr
Bloomington, IL 61701
Phone (309) 663-2100

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408492800000",
    "number": "1285856278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 SOUTHLAND DR",
            "address_2": "SUITE 1",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625214080",
            "telephone_number": "217-422-0311",
            "fax_number": "217-422-0416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 SOUTHLAND DR",
            "address_2": "SUITE 1",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625214080",
            "telephone_number": "217-422-0311",
            "fax_number": "217-422-0416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIRSETTY",
        "first_name": "ADARSH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2014-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036122575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.