Maamoun A Junidi, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

036047930 Issued in IL

Practice address

803 E Broadway
Centralia, IL 62801

Phone

(618) 532-4511

NPI assigned

Jun 22, 2006

Sex

Male

Sole proprietor

Yes

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.

• Illinois Department of Human Services

  • Intellectual Disabilities Intermediate Care Facility
  • Centralia, IL
  • NPI 1003960394

  IL

  Medicare reassignment NPD
• Physician Services Corporation of Southern Illinois Inc.

  • Internal Medicine Physician
  • Mount Vernon, IL
  • NPI 1831101807

  IL

  Medicare reassignment NPD
• St. Mary'S Hospital, Centralia, Illinois

  • Emergency Medicine Physician
  • Centralia, IL
  • NPI 1770687196

  IL

  Medicare reassignment NPD
• Illinois Department of Human Services

  • Psychiatric Hospital
  • Hines, IL
  • NPI 1902903487
  NPD
• St. Mary'S Hospital, Centralia, Illinois

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Centralia, IL
  • NPI 1710105192
  NPD
• Ambulatory Surgery Center of Centralia, LLC

  • Ambulatory Surgical Clinic/Center
  • Centralia, IL
  • NPI 1811957251
  NPD (past)
• Clarion Healing Center, LTD

  • Chiropractor
  • Carlyle, IL
  • NPI 1154330546
  NPD (past)

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 21, 2022.

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1366488660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 E BROADWAY",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "62801",
            "telephone_number": "618-532-4511",
            "fax_number": "618-532-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 E BROADWAY",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "62801",
            "telephone_number": "618-532-4511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 RICKER RD",
            "address_purpose": "LOCATION",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628814263",
            "country_code": "US",
            "telephone_number": "618-548-3194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUNIDI",
        "first_name": "MAAMOUN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036047930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036047930",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Marie Johnson, DPT
• Rae A Johnson
• Robin Lee Johnson, OD
• Virginia Lee Jones, CSADC
• Abdul L Junidi, D.D.S.
• Melissa Karaffa, APN
• Kaskaskia Special Ed Dist
• Kaskaskia Workshop, Inc.
• Kaskaskia Workshop, Inc.
• Carlie Michelle Kasten

• All providers in Centralia, IL
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.