NPIMap

Individual provider Active NPI

Bassim Assioun, M.D.

  • Nephrology Physician
  • O'Fallon, IL
National Provider Identifier
1669785408
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036137061 Issued in IL
Practice address
3 Saint Elizabeth Blvd Ste 5000
O Fallon, IL 62269-1282
Phone
(618) 641-5803
Fax
(618) 607-5116
NPI assigned
Jul 22, 2010
Last updated
Oct 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 2010015148 MO
Nephrology Physician 207RN0300X 036137061 IL Primary

Addresses

Primary practice location

3 Saint Elizabeth Blvd Ste 5000
O Fallon, IL 62269-1282

Mailing address

3 Saint Elizabeth Blvd Ste 5000
O Fallon, IL 62269-1282
Phone (618) 641-5803

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
I20150601000657 IL Practitioner - Nephrology 4183945330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HSHS Medical Group IncGroup PAC ID 5092857821, 212 clinicians

Practice addresses (Care Compare)

1512 N Green Mount Rd
Suite 108
Ofallon, IL 62269-1953
Phone (618) 624-5510

1900 E Lake Shore Dr
Suite 330
Decatur, IL 62521-3848
Phone (217) 423-2889

4500 Memorial Dr
Belleville, IL 62226-5360
Phone (618) 233-7750

904 Medical Park Dr
Effingham, IL 62401-2193
Phone (217) 540-2350

9515 Holy Cross Lane
Breese, IL 62230-3618
Phone (618) 526-4511

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036137061ILMDNephrology Physician
2010015148MOMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Prairie, Inc CurrentSince Jul 1, 2015 Accepting new patients
HSHS Prairie, Inc CurrentSince Jul 1, 2015 Accepting new patients
HSHS Medical Group Inc PastSince Oct 11, 2020 Accepting new patients

Locations

1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889

1512 N Green Mount Rd
O Fallon, IL 62269
Phone (618) 624-0100

3 Saint Elizabeth Blvd
Ste 5000
O Fallon, IL 62269
Phone (618) 641-5803

9515 Holy Cross Ln
Saint Rose, IL 62230
Phone (618) 526-4511

1116 Hartman Ln
Shiloh, IL 62221
Phone (618) 641-5803

3051 Hollis Dr
Fl 2
Springfield, IL 62704
Phone (217) 321-9321

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1669785408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SAINT ELIZABETH BLVD STE 5000",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691282",
            "telephone_number": "618-641-5803",
            "fax_number": "618-607-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SAINT ELIZABETH BLVD STE 5000",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691282",
            "telephone_number": "618-641-5803",
            "fax_number": "618-607-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASSIOUN",
        "first_name": "BASSIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-22",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "2010015148",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036137061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, IL

Sources for this page

Verify at the official NPI Registry.