Active NPI
Petras V Kisielius, MD
- Urology Physician
- Elmhurst, IL
National Provider Identifier
1447200563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 036068731
- Practice address
- 1200 S York St Ste 2000
Elmhurst, IL 60126-5634 - Phone
- (331) 221-9004
- Fax
- (331) 221-2748
- NPI assigned
- May 11, 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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | 036068731 | IL | Primary |
Addresses
Primary practice location
1200 S York St Ste 2000
Elmhurst, IL 60126-5634
Mailing address
4201 Winfield Rd FL 4
Warrenville, IL 60555-4025
Phone (331) 221-6377
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pkisielius41777@direct.edward.org | Direct |
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 Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elmhurst Memorial Oncology Services, LLC | Past | Accepting new patients | |
| Elmhurst Memorial Affiliated Primary Care Physicians, LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Elmhurst, IL
- NPI 1922244375
-
- Hematology & Oncology Physician
- Elmhurst, IL
- NPI 1306892419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624320000000",
"number": "1447200563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4201 WINFIELD RD FL 4",
"city": "WARRENVILLE",
"state": "IL",
"postal_code": "605554025",
"telephone_number": "331-221-6377",
"fax_number": "331-221-2357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 S YORK ST STE 2000",
"city": "ELMHURST",
"state": "IL",
"postal_code": "601265634",
"telephone_number": "331-221-9004",
"fax_number": "331-221-2748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISIELIUS",
"first_name": "PETRAS",
"middle_name": "V",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-11",
"last_updated": "2021-06-22",
"certification_date": "2021-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "IL",
"license": "036068731",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pkisielius41777@direct.edward.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1200 S York St Ste 2000",
"city": "Elmhurst",
"state": "IL",
"country_code": "US",
"postal_code": "601265634",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Elmhurst, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.