Individual provider Active NPI

Mansour Mohammadi Oroujeh, DO

  • Hospitalist Physician
  • Evanston, IL
National Provider Identifier
1518443308
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036154024 Issued in IL
Practice address
2650 Ridge Ave.
Im Hospitalists Ste 4210
Evanston, IL 60201-6686
Phone
(847) 570-1010
Fax
(847) 733-5108
NPI assigned
Jul 14, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036154024 IL
Internal Medicine Physician 207R00000X 125.071775 IL
Hospitalist Physician 208M00000X 036154024 IL Primary

Addresses

Primary practice location

2650 Ridge Ave.
Im Hospitalists Ste 4210
Evanston, IL 60201-6686

Mailing address

2650 Ridge Ave.
Im Hospitalists Ste 4210
Evanston, IL 60201-6686
Phone (847) 570-1010

Other practice location 1

5841 S Maryland Ave # Mc1052
Chicago, IL 60637-1443
Phone (630) 318-6243

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210226000059 IL Practitioner - HospitalistPractitioner - Internal Medicine 8123376696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1300 Oak Ave
Evanston, IL 60201-4205
Phone (847) 869-1300

2100 Pfingsten Rd
Glenview, IL 60026-1301

2650 Ridge Ave
Evanston, IL 60201-1700

777 Park Ave W
Highland Park, IL 60035-2433

9600 Gross Point Rd
Skokie, IL 60076-1214

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036154024ILMDInternal Medicine Physician
125.071775ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Internal Medicine CurrentSince May 25, 2021 Accepting new patients
Endeavor Health Medical Group CurrentSince Feb 17, 2021 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 4210
Evanston, IL 60201
Phone (847) 570-1010

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Ste 1304
Evanston, IL 60201
Phone (847) 570-1010

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1531526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1518443308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "IM HOSPITALISTS STE 4210",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602016686",
            "telephone_number": "847-570-1010",
            "fax_number": "847-733-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "IM HOSPITALISTS STE 4210",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602016686",
            "telephone_number": "847-570-1010",
            "fax_number": "847-733-5108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S Maryland Ave # Mc1052",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371443",
            "country_code": "US",
            "telephone_number": "630-318-6243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OROUJEH",
        "first_name": "MANSOUR",
        "middle_name": "MOHAMMADI",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-14",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036154024",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.071775",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036154024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.