Ifath G Bashiruddin, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

036085731 Issued in IL

Practice address

4550 Memorial Dr
Suite 360
Belleville, IL 62226-5359

Phone

(618) 239-9500

Fax

(618) 239-9555

NPI assigned

Aug 15, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

NephrologyAlso: Internal Medicine

Education

Other, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rashid a Dalal MD PCGroup PAC ID 2163459348, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• DaVita Metro East Dialysis Dialysis facility, Belleville, IL, CCN 142527
• FMC - Regency Park Dialysis facility, O Fallon, IL, CCN 142558
• DaVita Shiloh Dialysis Dialysis facility, Belleville, IL, CCN 142753
• Memorial Hospital Hospital, Belleville, IL, CCN 140185
• HSHS St Elizabeth'S Hospital Hospital, O Fallon, IL, CCN 140187
• St Josephs Hospital Hospital, Breese, IL, CCN 140145

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ifath.bashiruddin@direct.davitaphysiciansolutions.com

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.

• Rashid a Dalal MD PC

  • Nephrology Physician
  • Fairview Heights, IL
  • NPI 1053390484
  Medicare reassignment Care Compare group NPD

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

• Rai Care Centers of Illinois I, LLC

  dba Fresenius Medical Care Regency Park

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • O Fallon, IL
  • NPI 1588758239

  Dialysis facility

  Care Compare affiliation Name & address match
• Total Renal Care Inc

  dba Shiloh Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Belleville, IL
  • NPI 1871848895

  Dialysis facility

  Care Compare affiliation Name & address match
• Protestant Memorial Medical Center, Inc.

  dba Memorial Hospital

  • General Acute Care Hospital
  • Belleville, IL
  • NPI 1982796181
  Care Compare affiliation
• St Elizabeths Hospital of the Hospital Sisters of the Third Order

  dba HSHS St. Elizabeth's Hospital

  • General Acute Care Hospital
  • O Fallon, IL
  • NPI 1629057302
  Care Compare affiliation
• St Josephs Hospital Breese of the Hospital Sisters of the Third Orde

  dba Clinton County Rural Health

  • Rural Health Clinic/Center
  • Breese, IL
  • NPI 1013002658

  Hospital

  Care Compare affiliation
• St Josephs Hospital Breese of the Hospital Sisters of the Third Orde

  dba St. Joseph's Hospital

  • General Acute Care Hospital
  • Breese, IL
  • NPI 1457319154
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327968000000",
    "number": "1417060534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BEAVER CREEK CT",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633035497",
            "telephone_number": "618-239-9500",
            "fax_number": "618-239-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 MEMORIAL DR",
            "address_2": "SUITE 360",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265359",
            "telephone_number": "618-239-9500",
            "fax_number": "618-239-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASHIRUDDIN",
        "first_name": "IFATH",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2012-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036085731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "390007921",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085731",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raymond Barra, DMD
• Brooke Ashlynn Bartling
• William Lee Barton IV, M.ED., M.A.
• Naomi Barwick, SLP
• Naheed Talat Bashir, M.D.
• Karen Lynn Bassimer
• Jennifer Renee Bassler, CCC-SLP
• Jill M. Batchelder, SW
• Olivia J. Bateman, MSW
• Rose Ann Bates I, P.T.

• Nephrology Physician in Belleville, IL
• Providers in Belleville, IL by specialty
• Nephrology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2012; 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.

Verify at the official NPI Registry.