Individual provider Active NPI

Tamar Pounardjian, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1528683067
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036171134 Issued in IL
Practice address
1717 W Congress Pkwy
Chicago, IL 60612-3809
Phone
(312) 942-4200
NPI assigned
Jun 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X LP05045 RI
Hospitalist Physician 208M00000X 036171134 IL
Internal Medicine Physician 207R00000X 036171134 IL Primary

Addresses

Primary practice location

1717 W Congress Pkwy
Chicago, IL 60612-3809

Mailing address

1717 W Congress Pkwy
Chicago, IL 60612-3809
Phone (312) 942-4200

Other practice location 1

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-4741

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241009000286 IL Practitioner - Hospitalist 8527480078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Toledo Medical College, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1620 W Harrison St
Chicago, IL 60612-3801
Phone (312) 942-3034

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP05045RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Center Internal Medicine CurrentSince Oct 14, 2024 Accepting new patients
Rush University Medical Group Single Specialty CurrentSince Oct 14, 2024 Accepting new patients
Larabida Childrens Hospital PastSince Aug 25, 2024 Accepting new patients

Locations

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1620 W Harrison St
Chicago, IL 60612
Phone (312) 942-4200

75 Remittance Dr
Dept 1611
Chicago, IL 60675

Organizations & group practices 3

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": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1528683067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123809",
            "telephone_number": "312-942-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123809",
            "telephone_number": "312-942-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-4741",
            "fax_number": "401-444-4445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POUNARDJIAN",
        "first_name": "TAMAR",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-10",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP05045",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036171134",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036171134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.