Individual provider Active NPI

Joseph Porinchu Alenghat, MD

  • Diagnostic Radiology Physician
  • Bloomington, IL
National Provider Identifier
1366490658
Registry record updated Nov 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036-061493 Issued in IL
Practice address
1709 Jumer Dr
Suite B
Bloomington, IL 61704-0914
Phone
(309) 665-0640
Fax
(309) 664-6809
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2009

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 133436 NY
Diagnostic Radiology Physician 2085R0202X 101242282 VA
Diagnostic Radiology Physician 2085R0202X 036-061493 IL Primary
Diagnostic Radiology Physician 2085R0202X 7354 DC
Diagnostic Radiology Physician 2085R0202X 17757 CT
Diagnostic Radiology Physician 2085R0202X 43362 MA
Diagnostic Radiology Physician 2085R0202X 35.091085 OH

Addresses

Primary practice location

1709 Jumer Dr
Suite B
Bloomington, IL 61704-0914

Mailing address

1709 Jumer Dr
Suite B
Bloomington, IL 61704-0914
Phone (309) 665-0640

Other identifiers 3

IdentifierTypeStateIssuer
212545OtherILGROUP PTAN
036061493MedicaidIL
202926OtherILGROUP 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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17757CTMDDiagnostic Radiology Physician
7354DCMDDiagnostic Radiology Physician
036-061493ILMDDiagnostic Radiology Physician
43362MAMDDiagnostic Radiology Physician
133436NYMDDiagnostic Radiology Physician
35.091085OHMDDiagnostic Radiology Physician
101242282VAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City of Hope Medical Group of Illinois PLLC Past Accepting new patients
Central Illinois Neuroradiology, LTD PastSince Jan 1, 2008 Accepting new patients
Northwestern Medical Faculty Foundation Past Accepting new patients
Global Medical Imaging, SC Diagnostic Radiology Past Accepting new patients
Amerirad Inc Diagnostic Radiology Past Accepting new patients
Arlington Heights Radiology Center, LLC Past Accepting new patients

Organizations & group practices 6

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257292800000",
    "number": "1366490658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 JUMER DR",
            "address_2": "SUITE B",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617040914",
            "telephone_number": "309-665-0640",
            "fax_number": "309-664-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 JUMER DR",
            "address_2": "SUITE B",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617040914",
            "telephone_number": "309-665-0640",
            "fax_number": "309-664-6809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALENGHAT",
        "first_name": "JOSEPH",
        "middle_name": "PORINCHU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2009-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "133436",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "101242282",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036-061493",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "DC",
            "license": "7354",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "17757",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "43362",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.091085",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "212545",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036061493",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "202926",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.