Individual provider Active NPI

Samiha Sarkar

  • Pediatrics Physician
  • Springfield, IL
National Provider Identifier
1417571001
Registry record updated May 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
125076823 Issued in IL
Practice address
400 N 9TH St # 4a
Springfield, IL 62702-5310
Phone
(217) 545-8000
NPI assigned
May 30, 2020
Last updated
May 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125076823 IL Primary

Addresses

Primary practice location

400 N 9TH St # 4a
Springfield, IL 62702-5310

Mailing address

PO Box 19658
Springfield, IL 62794-9658

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230730000160 IL Practitioner - Pediatric Medicine 0446676266 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
125076823ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proctor Health Systems CurrentSince Jul 1, 2023 Accepting new patients
Carle Health Medical Group CurrentSince Jan 1, 2026 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Jul 1, 2025 Accepting new patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Proctor Health Systems CurrentSince Jul 1, 2023 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Jul 1, 2025 Accepting new patients

Locations

120 NE Glen Oak Ave
Peoria, IL 61603
Phone (309) 672-3158

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

221 NE Glen Oak Ave
#100
Peoria, IL 61636

2338 W Van Winkle Way
Ste 2200
Peoria, IL 61615
Phone (309) 692-6088

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

815 Main St
Ste A1
Peoria, IL 61602

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: samihasarkar@siusm.allscriptsdirect.net
  • Direct secure messaging: ssarkarmd388547@carlehiedirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1590796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590796800000",
    "number": "1417571001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19658",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N 9TH ST # 4A",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025310",
            "telephone_number": "217-545-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARKAR",
        "first_name": "SAMIHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-30",
        "last_updated": "2020-05-30",
        "certification_date": "2020-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125076823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.