NPIMap

Individual provider Active NPI

Farrukh A Kureishy, MD

  • Internal Medicine Physician
  • Clinton, IL
National Provider Identifier
1619950060
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036101594 Issued in IL
Practice address
422 W White St
Clinton, IL 61727-2272
Phone
(217) 935-9571
Fax
(217) 935-7603
NPI assigned
Nov 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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 036101594 IL Primary

Addresses

Primary practice location

422 W White St
Clinton, IL 61727-2272

Mailing address

422 W White St
Clinton, IL 61727-2272
Phone (217) 935-9571

Other identifiers 8

IdentifierTypeStateIssuer
036101594MedicaidIL
601024200OtherUS DEPT OF LABOR
02032003OtherILBLUE CROSS BLUE SHIELD
101594OtherOSF HEALTHPLANS
450314OtherHEALTHLINK
056153OtherHEALTH ALLIANCE
2191466OtherUNITED HEALTHCARE
7732279OtherAETNA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address farrukh.kureishy@direct.warnerhospital.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040325000213 IL Practitioner - Internal Medicine 3375433543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of Clinton 19 clinicians

Practice addresses (Care Compare)

422 W White St
Clinton, IL 61727-2272
Phone (217) 935-9571

Hospital & facility affiliations

  • Hospice Care of Illinois Hospice, Springfield, IL, CCN 141540
  • Warner Hospital and Health Services Hospital, Clinton, IL, CCN 141303
  • Decatur Memorial Hospital Hospital, Decatur, IL, CCN 140135
  • Abraham Lincoln Memorial Hospital Hospital, Lincoln, IL, CCN 141322
  • St Joseph Medical Center Hospital, Bloomington, IL, CCN 140162
  • Loft Rehab of Decatur Nursing home, Decatur, IL, CCN 145965
  • Loft Rehab of Rock Springs, the Nursing home, Decatur, IL, CCN 146003
  • Goldwater Care Clinton Nursing home, Clinton, IL, CCN 146076
  • The Haven of Arcola Nursing home, Arcola, IL, CCN 146050
  • Lincoln Village Healthcare Nursing home, Lincoln, IL, CCN 145719

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
City of Clinton Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

422 W White St
Clinton, IL 61727
Phone (217) 935-9570

Interoperability endpoints

  • Direct secure messaging: farrukh.kureishy@direct.warnerhospital.org

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Arcadia Care Bloomington LLCBloomington, IL, CCN 145371 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 1, 2020
Oct 1, 2020
Lincoln Village HealthcareLincoln, IL, CCN 145719 Skilled nursing facility Other
Adp of the SNF		 Jun 1, 2021
Jan 23, 2025
Goldwater Care ClintonClinton, IL, CCN 146076 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2024
Mar 1, 2024

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 10

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1619950060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 W WHITE ST",
            "city": "CLINTON",
            "state": "IL",
            "postal_code": "617272272",
            "telephone_number": "217-935-9571",
            "fax_number": "217-935-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 W WHITE ST",
            "city": "CLINTON",
            "state": "IL",
            "postal_code": "617272272",
            "telephone_number": "217-935-9571",
            "fax_number": "217-935-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUREISHY",
        "first_name": "FARRUKH",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036101594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036101594",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "601024200",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "02032003",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OSF HEALTHPLANS",
            "identifier": "101594",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "450314",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "056153",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2191466",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7732279",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "farrukh.kureishy@direct.warnerhospital.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "422 W White St",
            "city": "Clinton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "617272272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clinton, IL

Sources for this page

Verify at the official NPI Registry.