Active NPI
Ventrapragada S Mohan, M.D.
- Pulmonary Disease Physician
- Belleville, IL
National Provider Identifier
1649321183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 36056737
- Practice address
- 340 W Lincoln St Ste 300
Belleville, IL 62220-1900 - Phone
- (618) 235-4883
- Fax
- (618) 235-9573
- NPI assigned
- Jan 12, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 36056737 | IL | |
| Sleep Medicine (Internal Medicine) Physician | 207RS0012X | 36056737 | IL | |
| Internal Medicine Physician | 207R00000X | 35338 | MO | |
| Pulmonary Disease Physician | 207RP1001X | 36056737 | IL | Primary |
Addresses
Primary practice location
340 W Lincoln St Ste 300
Belleville, IL 62220-1900
Mailing address
340 W Lincoln St
300
Belleville, IL 62220-1900
Phone (618) 235-4883
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BLC21725 | Other | MO | BLUE CHOICE OF MISSOURI |
| 28568 | Other | MO | ANTHEM |
| 4606572 | Other | IL | AETNA |
| HEALTH PARTNERS | Other | IL | 300172 |
| HEALTH ALLIANCE | Other | IL | 88170 |
| 371067092002 | Other | IL | PRUDENTIAL |
| L013062 | Other | IL | TRICARE |
| 166028 | Other | IL | HEALTHLINK |
| 36056737 | Medicaid | IL | |
| 4469353002 | Other | IL | CIGNA |
| 4809004 | Other | IL | UNITED HEALTHCARE |
| CF6007 | Other | IL | RAILROAD MEDICARE |
| 08215136 | Other | IL | FEDERAL BLUE CROSS |
| 8215136 | Other | IL | BC BS OF IL |
| HARMONY | Other | IL | 235930 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35338 | MO | MD | Internal Medicine Physician |
| 36056737 | IL | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HSHS Medical Group Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Rural Health Clinic/Center
- Rushville, IL
- NPI 1487719480
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474588800000",
"number": "1649321183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 W LINCOLN ST",
"address_2": "300",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622201900",
"telephone_number": "618-235-4883",
"fax_number": "618-235-9573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 W LINCOLN ST STE 300",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622201900",
"telephone_number": "618-235-4883",
"fax_number": "618-235-9573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHAN",
"first_name": "VENTRAPRAGADA",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-12",
"last_updated": "2016-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "IL",
"license": "36056737",
"primary": false
},
{
"code": "207RS0012X",
"taxonomy_group": "",
"desc": "Internal Medicine, Sleep Medicine",
"state": "IL",
"license": "36056737",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "35338",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "IL",
"license": "36056737",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE OF MISSOURI",
"identifier": "BLC21725",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "28568",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4606572",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "300172",
"identifier": "HEALTH PARTNERS",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "88170",
"identifier": "HEALTH ALLIANCE",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRUDENTIAL",
"identifier": "371067092002",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "L013062",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "166028",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "36056737",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "4469353002",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "4809004",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CF6007",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL BLUE CROSS",
"identifier": "08215136",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS OF IL",
"identifier": "8215136",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "235930",
"identifier": "HARMONY",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.