Monissa Rajasri, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

125082430 Issued in IL

Practice address

102 S. Hennepin Ave
Dixon, IL 61021

Phone

(815) 285-8908

Fax

(815) 285-8926

NPI assigned

May 15, 2023

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Katherine Shaw Bethea Hospital

  • General Acute Care Hospital
  • Dixon, IL
  • NPI 1427043546
  Medicare reassignment NPD
• KSB Medical Group, Inc.

  • Family Medicine Physician
  • Dixon, IL
  • NPI 1073592119
  Medicare reassignment NPD
• KSB Medical Group, Inc.

  dba KSB Optical

  • Eyewear Supplier
  • Dixon, IL
  • NPI 1306814603
  NPD

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1508556333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 S. HENNEPIN AVE",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "61021",
            "telephone_number": "815-285-8908",
            "fax_number": "815-285-8926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S. HENNEPIN AVE",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "61021",
            "telephone_number": "815-285-8908",
            "fax_number": "815-285-8926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJASRI",
        "first_name": "MONISSA",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125082430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gail E Prendergast, M.D.
• Ann Sheree Prindaville, RN
• Kristine P Pultorak, D.O.
• Stephanie Ann Raimonde
• Christa Rose Raiter, MHP
• April R Ramirez, MS, LCPC
• Dan G. Ramirez
• Laura Eizabeth Rankin, MHP
• Monica Lynne Rasmussen, RN, BSN, CLC
• Sarah Suzanne Ready

• Family Medicine Physician in Dixon, IL
• Providers in Dixon, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.