Individual provider Active NPI

Michael Allen Cassaday, D.O.

  • Gastroenterology Physician
  • Moline, IL
National Provider Identifier
1427050673
Registry record updated Feb 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036097706 Issued in IL
Practice address
545 Valley View Dr
Moline, IL 61265-6138
Phone
(309) 762-5560
Fax
(309) 762-7351
NPI assigned
Jun 1, 2005
Last updated
Feb 28, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036097706 IL Primary

Addresses

Primary practice location

545 Valley View Dr
Moline, IL 61265-6138

Mailing address

545 Valley View Dr
Moline, IL 61265-6138
Phone (309) 762-5560

Other identifiers 1

IdentifierTypeStateIssuer
P00148242OtherRAILROAD MEDICARE

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1654IAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1427050673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 VALLEY VIEW DR",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656138",
            "telephone_number": "309-762-5560",
            "fax_number": "309-762-7351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 VALLEY VIEW DR",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656138",
            "telephone_number": "309-762-5560",
            "fax_number": "309-762-7351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSADAY",
        "first_name": "MICHAEL",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036097706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00148242",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; 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.