Imran Lashari Balouch, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

036132993 Issued in IL

Practice address

145 Union St
Echn Health Sevices
Vernon Rockville, CT 06066-3025

Phone

(860) 896-0377

NPI assigned

Jan 18, 2010

Last updated

Jan 10, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 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

GastroenterologyAlso: Internal Medicine

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
• St Mary Medical Center Hospital, Galesburg, IL, CCN 140064

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ibalouch391340@direct.myadvocateaurora.org

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Eastern Connecticut Medical Professionals Foundation Inc

  dba Eastern CT Medical Professionals

  • Family Medicine Physician
  • Manchester, CT
  • NPI 1770557712

  Gastroenterology

  NPD (past)

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

• St Mary Medical Center

  dba OSF Saint Mary Medical Center

  • General Acute Care Hospital
  • Galesburg, IL
  • NPI 1164485363
  Care Compare affiliation

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

{
    "created_epoch": "1263772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1467783290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 UNION ST",
            "city": "VERNON ROCKVILLE",
            "state": "CT",
            "postal_code": "060663025",
            "telephone_number": "860-896-0377",
            "fax_number": "860-896-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 UNION ST",
            "address_2": "ECHN HEALTH SEVICES",
            "city": "VERNON ROCKVILLE",
            "state": "CT",
            "postal_code": "060663025",
            "telephone_number": "860-896-0377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17850 Kedzie Ave Ste 3500",
            "address_purpose": "LOCATION",
            "city": "Hazel Crest",
            "state": "IL",
            "postal_code": "604292082",
            "country_code": "US",
            "telephone_number": "708-957-4011",
            "fax_number": "708-957-4013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALOUCH",
        "first_name": "IMRAN",
        "middle_name": "LASHARI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-18",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036132993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4996078",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9808521",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ibalouch391340@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17850 Kedzie Ave Ste 3500",
            "city": "Hazel Crest",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604292082",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "17850 Kedzie Ave Ste 3500",
            "city": "Hazel Crest",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604292082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• 22 South Street Operations LLC (Fox Hill Center)
• Cynthia Drowaa Agyeman, PHARMD
• Alzahraa Salam Khalid Alhameedawi, PHARMD
• Beacon Pharmacy LLC (Rockville Pharmacy)
• Beacon Prescription,Inc
• Diane Marie Blackwood, LMSW LADC
• Bolbol LLC (The Medicine Shoppe 1442)
• Deanna Carter

• Gastroenterology Physician in Vernon Rockville, CT
• Providers in Vernon Rockville, CT by specialty
• Gastroenterology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.