Moshe Dissen

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036149851 Issued in IL

Practice address

2845 N Sheridan Rd Ste 801
Chicago, IL 60657

Phone

(773) 665-6851

NPI assigned

Apr 17, 2016

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

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

Internal Medicine

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Prime Healthcare Illinois Medical Group LLCGroup PAC ID 5597275685, 278 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Hospital-Evanston Hospital, Evanston, IL, CCN 140080
• Presence Saint Joseph Hospital - Chicago Hospital, Chicago, IL, CCN 140224
• Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
• Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
• Amita Health Resurrection Medical Center Hospital, Chicago, IL, CCN 140117
• Holy Family Medical Center Long-term care hospital, Des Plaines, IL, CCN 142011

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Prime Healthcare Illinois Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Des Plaines, IL
  • NPI 1023837689

  Internal Medicine

  Medicare reassignment Care Compare group NPD

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

• Endeavor Health Clinical Operations

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1184670549
  Care Compare affiliation
• Holy Family Medical Center - Des Plaines LLC

  • Long Term Care Hospital
  • Des Plaines, IL
  • NPI 1205674611

  Long-term care hospital

  Care Compare affiliation
• Northwestern Memorial Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1497859649
  Care Compare affiliation
• Presence Chicago Hospitals Network

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1679659585
  Care Compare affiliation
• Resurrection Medical Center - Chicago LLC

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1811735228
  Care Compare affiliation
• Saint Francis Hospital - Evanston LLC

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1982442398
  Care Compare affiliation

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

{
    "created_epoch": "1460851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1487008389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 N SHERIDAN RD STE 801",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "773-665-6851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 N SHERIDAN RD STE 801",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "773-665-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISSEN",
        "first_name": "MOSHE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-17",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036149851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marco Antonio Dispagna, MD
• Dispatchhealth-Arizona
• Karl F Disque, D.O. RPH
• Vinodinee Lanka Dissanayake, M.D.
• John Louis Disselhorst
• Justine Distel, OTD; OTR/L
• Adijatu Disu
• Talia Ruth Ditkoff
• Lorelei Elizabeth Ditommaso, M.D., M.P.H.
• Rebecca Mae Helm Dittburner, LCSW

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.