Active NPI
Asad Qalbani, M.D.
- Psychiatry Physician
- Chicago, IL
National Provider Identifier
1659543874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- C168670
- Practice address
- 1740 W Taylor St
Chicago, IL 60612-7232 - Phone
- (866) 600-2273
- NPI assigned
- Mar 27, 2008
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 036.119633 | IL | |
| Psychiatry Physician | 2084P0800X | C168670 | CA | Primary |
| Psychiatry Physician | 2084P0800X | TD081067 | ME |
Addresses
Primary practice location
1740 W Taylor St
Chicago, IL 60612-7232
Mailing address
1400 Emeline Ave
Santa Cruz, CA 95060-1976
Phone (831) 454-4170
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
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.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.119633 | IL | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Santa Cruz | Current | Accepting new patients | |
| County of Santa Cruz | Current | Accepting new patients |
Locations
1400 Emeline Ave
Santa Cruz, CA 95060
Phone (831) 454-4900
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.
-
- Clinic/Center
- Santa Cruz, CA
- NPI 1659315430
-
dba Watsonville Health Center
- Federally Qualified Health Center (FQHC)
- Watsonville, CA
- NPI 1770709149
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623196800000",
"number": "1659543874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 EMELINE AVE",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "950601976",
"telephone_number": "831-454-4170",
"fax_number": "831-454-4663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 W TAYLOR ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606127232",
"telephone_number": "866-600-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QALBANI",
"first_name": "ASAD",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-27",
"last_updated": "2021-06-09",
"certification_date": "2021-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "IL",
"license": "036.119633",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "C168670",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "ME",
"license": "TD081067",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.