Active NPI
Hassan Golchini, MD
- Hospitalist Physician
- Pekin, IL
National Provider Identifier
1497846935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 35.087712
- Practice address
- 600 S 13TH St
Suite M
Pekin, IL 61554-4936 - Phone
- (309) 353-0825
- Fax
- (309) 347-1246
- NPI assigned
- Sep 28, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35.087712 | OH | |
| Hospitalist Physician | 208M00000X | 036120513 | IL | |
| Hospitalist Physician | 208M00000X | 35.087712 | OH | Primary |
Addresses
Primary practice location
600 S 13TH St
Suite M
Pekin, IL 61554-4936
Mailing address
600 S 13TH St
Suite M
Pekin, IL 61554-4936
Phone (309) 353-0825
Other practice location 1
405 W Grand Ave
Dayton, OH 45405-7538
Phone (937) 723-3276
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2695490 | Medicaid | OH | |
| 9015685 | Other | BCBS | |
| R01334 | Other | PTAN |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | hgolchini54752@direct.ketteringhealth.org | ||
| FHIR URL | https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/ |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.087712 | OH | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montgomery Hospitalists LLC | Hospitalist | Past | Accepting new patients |
| Incare LLC | Internal Medicine | Past | Accepting new patients |
| Kenwood Hospitalists, LLC | Internal Medicine | Past | Accepting new patients |
| Kindred Hospitals East, LLC | Past | Accepting new patients |
Interoperability endpoints
- hgolchini654752@direct.ketteringhealth.org
Organizations & group practices 4
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.
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- Long Term Care Hospital
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- NPI 1447320676
-
- Hospitalist Physician
- Cincinnati, OH
- NPI 1013158815
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649203200000",
"number": "1497846935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 S 13TH ST",
"address_2": "SUITE M",
"city": "PEKIN",
"state": "IL",
"postal_code": "615544936",
"telephone_number": "309-353-0825",
"fax_number": "309-347-1246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 S 13TH ST",
"address_2": "SUITE M",
"city": "PEKIN",
"state": "IL",
"postal_code": "615544936",
"telephone_number": "309-353-0825",
"fax_number": "309-347-1246"
}
],
"practiceLocations": [
{
"address_1": "405 W Grand Ave",
"address_purpose": "LOCATION",
"city": "Dayton",
"state": "OH",
"postal_code": "454057538",
"country_code": "US",
"telephone_number": "937-723-3276",
"fax_number": "937-723-3277",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOLCHINI",
"first_name": "HASSAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2022-04-06",
"certification_date": "2022-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35.087712",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "IL",
"license": "036120513",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "OH",
"license": "35.087712",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2695490",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "9015685",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "R01334",
"state": null
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "hgolchini54752@direct.ketteringhealth.org",
"affiliation": "N",
"address_1": "405 W Grand Ave",
"city": "Dayton",
"state": "OH",
"country_code": "US",
"postal_code": "454057538",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
"affiliation": "N",
"address_1": "405 W Grand Ave",
"city": "Dayton",
"state": "OH",
"country_code": "US",
"postal_code": "454057538",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Pekin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.