Individual provider Active NPI

Narendra M Desai, MD

  • Otolaryngology Physician
  • Gurnee, IL
National Provider Identifier
1669449336
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
036057233 Issued in IL
Practice address
222 S Greenleaf St Ste 102
Gurnee, IL 60031-5705
Phone
(847) 662-4442
Fax
(847) 662-4446
NPI assigned
Mar 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 036057233 IL Primary

Addresses

Primary practice location

222 S Greenleaf St Ste 102
Gurnee, IL 60031-5705

Mailing address

222 S Greenleaf St Ste 102
Gurnee, IL 60031-5705
Phone (847) 662-4442

Other identifiers 1

IdentifierTypeStateIssuer
036057233MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address ndesai235680@direct.myadvocateaurora.org Direct

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
I20071108000028 IL Practitioner - Otolaryngology 9830286814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake County Head and Neck Specialists S.C.Group PAC ID 3476640459, 8 clinicians

Practice addresses (Care Compare)

222 S Greenleaf St
Suite 102
Gurnee, IL 60031-5705
Phone (847) 662-4442

Hospital & facility affiliations

  • Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036057233ILMDOtolaryngology Physician
036093674ILMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake County Head and Neck Specialists S.C. Otolaryngology CurrentSince Nov 7, 2007 Accepting new patients
West Suburban Head and Neck Specialists,S.C. Otolaryngology Past Accepting new patients

Locations

222 S Greenleaf St
Ste 102
Gurnee, IL 60031
Phone (847) 662-4442

222 S Greenleaf St
Ste 106
Gurnee, IL 60031
Phone (847) 356-8205

1880 W Winchester Rd
Ste 103
Libertyville, IL 60048
Phone (847) 367-5770

Interoperability endpoints

  • Direct secure messaging: narendra.desai.1@32683.direct.athenahealth.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 4

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": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1669449336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S GREENLEAF ST STE 102",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315705",
            "telephone_number": "847-662-4442",
            "fax_number": "847-662-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S GREENLEAF ST STE 102",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315705",
            "telephone_number": "847-662-4442",
            "fax_number": "847-662-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "NARENDRA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036057233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036057233",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "222 S Greenleaf St Ste 102",
            "city": "Gurnee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600315705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ndesai235680@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "222 S Greenleaf St Ste 102",
            "city": "Gurnee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600315705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

Verify at the official NPI Registry.