Active NPI
Parviz B. Sanjabi, MD
- Pulmonary Disease Physician
- Carbondale, IL
National Provider Identifier
1336393875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 036051114
- Practice address
- 1335 Cedar Court
Carbondale, IL 62901 - Phone
- (618) 457-8520
- Fax
- (618) 457-8560
- NPI assigned
- Nov 11, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 036051114 | IL | Primary |
Addresses
Primary practice location
1335 Cedar Court
Carbondale, IL 62901
Mailing address
P O Box 577
Carterville, IL 62918-0577
Phone (618) 985-8221
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036051114 | Medicaid | IL | |
| CF3444 | Other | IL | MEDICARE RR GROUP |
| 133133805 | Other | IL | DOL BLACK LUNG |
| 370966854018 | Medicaid | IL | |
| 640701001 | Other | IL | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303171200000",
"number": "1336393875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 577",
"city": "CARTERVILLE",
"state": "IL",
"postal_code": "629180577",
"telephone_number": "618-985-8221",
"fax_number": "618-985-6860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1335 CEDAR COURT",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "62901",
"telephone_number": "618-457-8520",
"fax_number": "618-457-8560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANJABI",
"first_name": "PARVIZ",
"middle_name": "B.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-11-11",
"last_updated": "2011-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "IL",
"license": "036051114",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036051114",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR GROUP",
"identifier": "CF3444",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DOL BLACK LUNG",
"identifier": "133133805",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "370966854018",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "640701001",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carbondale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.