Active NPI
Hassan Kieso
- Cardiovascular Disease Physician
- Olympia Fields, IL
National Provider Identifier
1407812050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 036092223
- Practice address
- 3800 W 203Rd St
Suite 204
Olympia Fields, IL 60461-1184 - Phone
- (708) 679-2670
- Fax
- (708) 503-3260
- NPI assigned
- Apr 24, 2006
- 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 |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 036092223 | IL | Primary |
Addresses
Primary practice location
3800 W 203Rd St
Suite 204
Olympia Fields, IL 60461-1184
Mailing address
1040 Sierra Drive
Suite 400
Greenwood, IN 46143-7241
Phone (317) 528-4253
Other practice location 1
101 E Miller Rd
Sterling, IL 61081-1252
Phone (815) 625-4790
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036092223 | Medicaid | IL | |
| L95559 | Other | IL | MEDICARE 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 1972
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
101 E Miller Rd
Sterling, IL 61081-1252
Phone (815) 625-4790
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 38.76 of 100
- Quality
- 0
- Improvement activities
- 40
- Cost
- 75.61
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 24 |
| Pacemaker insertion or repair | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036092223 | IL | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CGH Medical Center | Current | Accepting new patients | |
| Edward Cardiovascular Institute | Cardiovascular Disease | Past | Accepting new patients |
| Midwest Heart Specialists, LTD | Cardiovascular Disease | Past | Accepting new patients |
Locations
101 E Miller Rd
Sterling, IL 61081
Phone (815) 632-5285
Interoperability endpoints
- hkieso20010@cghmc.direct-ci.com
Organizations & group practices 4
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.
-
- General Acute Care Hospital
- Sterling, IL
- NPI 1902854623
-
dba CGH Medical Center-Main Clinic
- Family Medicine Physician
- Sterling, IL
- NPI 1548540636
-
- Cardiovascular Disease Physician
- Naperville, IL
- NPI 1649386400
-
- Cardiovascular Disease Physician
- Downers Grove, IL
- NPI 1417908765
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Sterling, IL
- NPI 1902854623
-
- Critical Access Hospital
- Morrison, IL
- NPI 1184844938
-
dba OSF Saint Clare Medical Center
- Critical Access Hospital
- Princeton, IL
- NPI 1093308439
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578614400000",
"number": "1407812050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1040 SIERRA DRIVE",
"address_2": "SUITE 400",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461437241",
"telephone_number": "317-528-4253",
"fax_number": "317-865-8319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 W 203RD ST",
"address_2": "SUITE 204",
"city": "OLYMPIA FIELDS",
"state": "IL",
"postal_code": "604611184",
"telephone_number": "708-679-2670",
"fax_number": "708-503-3260"
}
],
"practiceLocations": [
{
"address_1": "101 E Miller Rd",
"address_purpose": "LOCATION",
"city": "Sterling",
"state": "IL",
"postal_code": "610811252",
"country_code": "US",
"telephone_number": "815-625-4790",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIESO",
"first_name": "HASSAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-24",
"last_updated": "2020-01-10",
"certification_date": "2020-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IL",
"license": "036092223",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036092223",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "L95559",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olympia Fields, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.