Individual provider Active NPI

Rajeev Sai Polasani, MD

  • Diagnostic Radiology Physician
  • Evanston, IL
National Provider Identifier
1548319239
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD428312 Issued in PA
Practice address
2650 Ridge Ave.
Department of Radiology
Evanston, IL 60201-1057
Phone
(847) 570-2477
Fax
(847) 570-2942
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD428312 PA Primary
Neuroradiology Physician 2085N0700X 036120474 IL

Addresses

Primary practice location

2650 Ridge Ave.
Department of Radiology
Evanston, IL 60201-1057

Mailing address

2650 Ridge Ave.
Department of Radiology
Evanston, IL 60201-1057
Phone (847) 570-2477

Other practice location 1

3400 Spruce St
1 Maloney Building
Philadelphia, PA 19104-4206
Phone (215) 662-3957

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
I20090219000035 IL Practitioner - Diagnostic Radiology 8022112754 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2001
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)

2650 Ridge Ave
Suite 2218a
Evanston, IL 60201-1700
Phone (847) 503-4222

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Swedish Hospital Hospital, Chicago, IL, CCN 140114
  • Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Elmhurst Memorial Hospital Hospital, Elmhurst, IL, CCN 140200

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Mar 1, 2022 Accepting new patients
Endeavor Health Medical Group CurrentSince Mar 1, 2022 Accepting new patients
Radiology Subspecialists of Northern Illinois, LLC Diagnostic Radiology CurrentSince Oct 18, 2016 Accepting new patients
Central Dupage Hospital Association CurrentSince Apr 8, 2009 Accepting new patients
Central Dupage Hospital Association CurrentSince Apr 8, 2009 Accepting new patients
Winfield Pathology Consultants, S.C. Current Accepting new patients
Trustees of the University of Pennsylvania Past Accepting new patients
Univ of Penn Community Radiology Neuroradiology Past Accepting new patients

Locations

Dept 4698
Carol Stream, IL 60122

9532 Eagle Way
Chicago, IL 60678

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

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

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

825 W State St
Ste 103E
Geneva, IL 60134

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Interoperability endpoints

  • Direct secure messaging: rpolasani287766@direct.edward.org

Organizations & group practices 8

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 6

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1548319239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011057",
            "telephone_number": "847-570-2477",
            "fax_number": "847-570-2942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011057",
            "telephone_number": "847-570-2477",
            "fax_number": "847-570-2942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Spruce St",
            "address_2": "1 Maloney Building",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044206",
            "country_code": "US",
            "telephone_number": "215-662-3957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLASANI",
        "first_name": "RAJEEV",
        "middle_name": "SAI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD428312",
            "primary": true
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "IL",
            "license": "036120474",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.