Individual provider Active NPI

Ramaprasad Konanur, M.D

  • Hospitalist Physician
  • Normal, IL
National Provider Identifier
1336172121
Registry record updated Aug 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036-111825 Issued in IL
Practice address
1300 Franklin Ave
Suite 250
Normal, IL 61761-3592
Phone
(309) 268-3589
Fax
(309) 268-2536
NPI assigned
Jul 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 036-111825 IL Primary

Addresses

Primary practice location

1300 Franklin Ave
Suite 250
Normal, IL 61761-3592

Mailing address

1300 Franklin Ave
Suite 250
Normal, IL 61761-3592
Phone (309) 268-3589

Other identifiers 5

IdentifierTypeStateIssuer
P00183517OtherILMEDICARE RAILROAD
36111825MedicaidIL
95016OtherILHEALTHALLIANCE
5715390OtherILBCBS
809840018OtherILMEDICARE INDIVIDUAL PTAN

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
I20040924000788 IL Practitioner - HospitalistPractitioner - Internal Medicine 9739158932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1991
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)

530 Neglen Oak Ave
Peoria, IL 61637-0001
Phone (309) 624-8818

Hospital & facility affiliations

  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-111825ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients

Locations

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249344000000",
    "number": "1336172121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 FRANKLIN AVE",
            "address_2": "SUITE 250",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613592",
            "telephone_number": "309-268-3589",
            "fax_number": "309-268-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 FRANKLIN AVE",
            "address_2": "SUITE 250",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613592",
            "telephone_number": "309-268-3589",
            "fax_number": "309-268-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONANUR",
        "first_name": "RAMAPRASAD",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2009-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036-111825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00183517",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36111825",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHALLIANCE",
            "identifier": "95016",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5715390",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PTAN",
            "identifier": "809840018",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

Verify at the official NPI Registry.