Individual provider Active NPI

Mohamed Kaseer Ghumra, MD

  • Neurology Physician
  • Elgin, IL
National Provider Identifier
1629094834
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036-386778 Issued in IL
Practice address
750 Fletcher Drive
Suite 204
Elgin, IL 60123-4736
Phone
(847) 931-4626
Fax
(847) 931-4794
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 036-386778 IL Primary

Addresses

Primary practice location

750 Fletcher Drive
Suite 204
Elgin, IL 60123-4736

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-2000

Other identifiers 3

IdentifierTypeStateIssuer
036086778MedicaidIL
P00098316OtherILRAILROAD MEDICARE
0004923104OtherILBLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mghumra186456@direct.edward.org

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
I20041124000094 IL Practitioner - Neurology 2961467477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

1325 N Meacham Rd
Schaumburg, IL 60173-4824
Phone (630) 469-9200

2100 Glenwood Ave
Joliet, IL 60435-5487
Phone (815) 725-2121

30 Stratford Dr
Bloomingdale, IL 60108-2201
Phone (630) 893-2210

40 S Clay St
Hinsdale, IL 60521-3257

4205 Westbrook Dr
Aurora, IL 60504-4124
Phone (630) 527-1818

430 Pennsylvania Ave
Glen Ellyn, IL 60137-4464
Phone (630) 469-9200

430 Warrenville Rd
Suite 210
Lisle, IL 60532-1348
Phone (630) 432-6180

Hospital & facility affiliations

  • F J Home Health Care Inc Home health agency, Evergreen Park, IL, CCN 147737
  • Advocate Sherman Hospital Hospital, Elgin, IL, CCN 140030
  • Saint Joseph Hospital-Elgin Hospital, Elgin, IL, CCN 140217
  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223
  • Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-386778ILMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Jan 14, 2019 Accepting new patients
Dupage Medical Group LTD CurrentSince Jan 14, 2019 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

750 Fletcher Dr
Ste 204
Elgin, IL 60123
Phone (847) 931-4526

750 Fletcher Dr
Elgin, IL 60123
Phone (847) 531-5974

Interoperability endpoints

  • Direct secure messaging: mghumra186456@dulyhealthandcare.direct-ci.com

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 8

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1629094834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 FLETCHER DRIVE",
            "address_2": "SUITE 204",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234736",
            "telephone_number": "847-931-4626",
            "fax_number": "847-931-4794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHUMRA",
        "first_name": "MOHAMED",
        "middle_name": "KASEER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036-386778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086778",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00098316",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0004923104",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mghumra186456@direct.edward.org",
            "affiliation": "N",
            "address_1": "750 Fletcher Drive",
            "address_2": "Suite 204",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601234736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.