Individual provider Active NPI

Sameer Mateen Naseeruddin, M.D.

  • Internal Medicine Physician
  • Schaumburg, IL
National Provider Identifier
1578627964
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036112407 Issued in IL
Practice address
1102 S Roselle Rd
Schaumburg, IL 60193-4072
Phone
(847) 924-6626
Fax
(847) 882-1810
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036112407 IL Primary

Addresses

Primary practice location

1102 S Roselle Rd
Schaumburg, IL 60193-4072

Mailing address

1102 S Roselle Rd
Schaumburg, IL 60193-4072
Phone (847) 924-6626

Other identifiers 1

IdentifierTypeStateIssuer
036112407MedicaidIL

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
I20041207000209 IL Practitioner - Internal Medicine 5092771071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1102 S Roselle Rd
Schaumburg, IL 60193-4004
Phone (847) 882-1438

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036112407ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skypoint Medical Center, SC Internal Medicine CurrentSince Oct 3, 2004 Accepting new patients
Suburban Home Physicians,LLC Internal Medicine Past Accepting new patients
Fahey Medical Center S.C. Past Accepting new patients
American Home Visiting Physicians Past Accepting new patients

Locations

1140 S Roselle Rd
Schaumburg, IL 60193
Phone (847) 385-4828

1102 S Roselle Rd
Schaumburg, IL 60193
Phone (847) 301-7773

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8847/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1578627964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 S ROSELLE RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601934072",
            "telephone_number": "847-924-6626",
            "fax_number": "847-882-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 S ROSELLE RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601934072",
            "telephone_number": "847-924-6626",
            "fax_number": "847-882-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASEERUDDIN",
        "first_name": "SAMEER",
        "middle_name": "MATEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036112407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112407",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.