Sudeep Nair, MD

Key facts

NPI

1376582999

Entity type

Individual (NPI type 1)

Primary specialty

Internal Medicine Physician 207R00000X

License

036092998 (IL)

Practice address

602 S 42ND St
Suite B
Mount Vernon, IL 62864-6264

Phone

(618) 899-3777

Fax

(618) 242-2378

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

No

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 and National Provider Directory roles.

• Physician Services Corporation of Southern Illinois Inc. Internal Medicine Physician · Mount Vernon, IL · NPI 1831101807
  Medicare reassignment Care Compare group NPD IL · INTERNAL MEDICINE

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Deaconess Illinois Crossroads Inc General Acute Care Hospital · Mount Vernon, IL · NPI 1124745807
  Care Compare affiliation Hospital
• Fairfield Memorial Hospital Association Critical Access Hospital · Fairfield, IL · NPI 1255422416
  Care Compare affiliation Hospital
• Good Samaritan Regional Health Center General Acute Care Hospital · Mount Vernon, IL · NPI 1609897339
  Care Compare affiliation Hospital
• LHCG Xxxvii, LLC Home Health Agency · Marion, IL · NPI 1740527407
  Care Compare affiliation Home health agency
• Palladian Mt Vernon SNF LLC Skilled Nursing Facility · Mount Vernon, IL · NPI 1033107248
  Care Compare affiliation Nursing home
• Southern Illinois Hospital Services General Acute Care Hospital · Carbondale, IL · NPI 1093801797
  Care Compare affiliation Hospital
• SSM Health Businesses Community Based Hospice Care Agency · Mount Vernon, IL · NPI 1093718900
  Care Compare affiliation Hospice
• SSM Health Businesses Home Health Agency · Mount Vernon, IL · NPI 1295798403
  Care Compare affiliation Home health agency
• St Mary'S Hospital, Centralia, Illinois General Acute Care Hospital · Centralia, IL · NPI 1083617245
  Care Compare affiliation Hospital

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Good Samaritan Regional Health Center Rehabilitation Hospital Unit · Mount Vernon, IL · NPI 1043270424
  CMS ownership CORPORATE DIRECTOR
• Good Samaritan Regional Health Center General Acute Care Hospital · Mount Vernon, IL · NPI 1609897339
  CMS ownership CORPORATE DIRECTOR
• Physician Services Corporation of Southern Illinois Inc. Internal Medicine Physician · Mount Vernon, IL · NPI 1831101807
  CMS ownership CORPORATE DIRECTOR
• St Mary'S Hospital, Centralia, Illinois General Acute Care Hospital · Centralia, IL · NPI 1083617245
  CMS ownership CORPORATE DIRECTOR
• St. Mary'S Hospital, Centralia, Illinois Psychiatric Hospital Unit · Centralia, IL · NPI 1255391611
  CMS ownership CORPORATE DIRECTOR

Medicare Care Compare profile

Specialty

Internal Medicine

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Select Physical Therapy Holdings Inc (1,992 clinicians)
Physician Services Corporation of Southern Illinois Inc (120 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health at Home Health-Illinois Home health agency · Mount Vernon, IL · CCN 147088
• LHC-Illinois Home Health Care Home health agency · Marion, IL · CCN 147716
• SSM Hospice of Illinois Hospice · Mount Vernon, IL · CCN 141530
• Good Samaritan Regional HLTH Center Hospital · Mount Vernon, IL · CCN 140046
• SSM Health St Mary'S Hospital -Centralia Hospital · Centralia, IL · CCN 140034
• Deaconess Illinois Crossroads Hospital · Mount Vernon, IL · CCN 140294
• Fairfield Memorial Hospital 1 Hospital · Fairfield, IL · CCN 141311
• Memorial Hospital of Carbondale Hospital · Carbondale, IL · CCN 140164
• Mount Vernon Countryside Manor Nursing home · Mount Vernon, IL · CCN 145685

Medicare participation

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: snair76654@direct-ehr-ssmhc.com

Specialties & licenses

Addresses

Other identifiers

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 1, 2020.

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1376582999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 S 42ND ST",
            "address_2": "SUITE B",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646264",
            "telephone_number": "618-899-3777",
            "fax_number": "618-242-2378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 S 42ND ST",
            "address_2": "SUITE B",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646264",
            "telephone_number": "618-899-3777",
            "fax_number": "618-242-2378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIR",
        "first_name": "SUDEEP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036092998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR GROUP NUMBER",
            "identifier": "CK7203",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110143249",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036092998",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "04108653",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "snair76654@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "snair76654@direct-ehr-ssmhc.com",
            "address_1": "602 S 42nd St",
            "address_2": "Suite B",
            "city": "Mount Vernon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628646264",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "602 S 42nd St",
            "address_2": "Suite B",
            "city": "Mount Vernon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628646264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Vernon, IL

• Laurie Mulvaney, S.T.
• Scott Murfin, DPT
• Michael Murray, PA-C
• Scott Murray, LCSW
• Brandon Nabors, MA, QMHP
• National Healthcare of Mt Vernon Inc
• National Healthcare of Mt Vernon Inc
• National Healthcare of Mt Vernon Inc
• National Healthcare of Mt Vernon Inc
• National Healthcare of Mt Vernon Inc

All providers in Mount Vernon, IL · Internal Medicine Physician in Illinois