Individual provider Active NPI

Mehjabeen Naseer, DO

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1295099901
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036138073 Issued in IL
Practice address
5145 N California Ave
Swedish Covenant Hospital- Medical Education Dept
Chicago, IL 60625-3661
Phone
(773) 878-8200
Fax
(773) 989-1648
NPI assigned
Jun 27, 2012
Last updated
Oct 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036138073 IL Primary

Addresses

Primary practice location

5145 N California Ave
Swedish Covenant Hospital- Medical Education Dept
Chicago, IL 60625-3661

Mailing address

5140 N California Ave Ste 700
Chicago, IL 60625-3657
Phone (773) 784-2101

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
I20190319001280 IL Practitioner - Family Practice 3072853605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Humayun S S CGroup PAC ID 9537077037, 6 clinicians

Practice addresses (Care Compare)

5140 N California Ave
Suite 700
Chicago, IL 60625-3657
Phone (773) 784-2101

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036138073ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Humayun S S C Family Medicine CurrentSince Jan 27, 2019 Accepting new patients

Locations

2740 W Foster Ave
Ste 105
Chicago, IL 60625
Phone (773) 784-2101

5140 N California Ave
Ste 700
Chicago, IL 60625
Phone (773) 784-2101

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AHIDAD

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 3

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": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1295099901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 N CALIFORNIA AVE STE 700",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253657",
            "telephone_number": "773-784-2101",
            "fax_number": "773-784-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5145 N CALIFORNIA AVE",
            "address_2": "SWEDISH COVENANT HOSPITAL- MEDICAL EDUCATION DEPT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253661",
            "telephone_number": "773-878-8200",
            "fax_number": "773-989-1648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASEER",
        "first_name": "MEHJABEEN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036138073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.