NPIMap

Individual provider Active NPI

Hassnain Safdar Syed, M.D.

  • Family Medicine Physician
  • Minooka, IL
National Provider Identifier
1669798542
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036125457 Issued in IL
Practice address
603 W Mondamin St
Minooka, IL 60447-9057
Phone
(815) 521-1010
Fax
(815) 521-1826
NPI assigned
Apr 16, 2010
Last updated
Jul 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036125457 IL Primary

Addresses

Primary practice location

603 W Mondamin St
Minooka, IL 60447-9057

Mailing address

725 School St Ste a
Morris, IL 60450-1207
Phone (815) 942-2932

Other identifiers 1

IdentifierTypeStateIssuer
036-125457MedicaidIL

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
I20101210000278 IL Practitioner - Family PracticePractitioner - Emergency Medicine 7315134764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morris HospitalGroup PAC ID 1850372459, 115 clinicians

Practice addresses (Care Compare)

603 W Mondamin St
Minooka, IL 60447-9057
Phone (815) 581-1010

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036125457ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Morris Hospital CurrentSince Jul 4, 2014 Accepting new patients
Morris Hospital CurrentSince Jul 4, 2014 Accepting new patients
Morris Hospital Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Morris Hospital Family Medicine Past Accepting new patients

Locations

4 E North St
Coal City, IL 60416
Phone (815) 518-5755

580 Sycamore St
Marseilles, IL 61341
Phone (815) 795-2122

603 W Mondamin St
Minooka, IL 60447
Phone (815) 521-1010

150 W High St
Morris, IL 60450
Phone (815) 942-2129

425 E US Route 6
Ste A
Morris, IL 60450
Phone (815) 513-5254

725 School St
Ste A
Morris, IL 60450

Interoperability endpoints

  • Direct secure messaging: hassnain.syed@direct-address.org

Organizations & group practices 5

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 7

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": "1271376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1669798542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 SCHOOL ST STE A",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604501207",
            "telephone_number": "815-942-2932",
            "fax_number": "815-941-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 W MONDAMIN ST",
            "city": "MINOOKA",
            "state": "IL",
            "postal_code": "604479057",
            "telephone_number": "815-521-1010",
            "fax_number": "815-521-1826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYED",
        "first_name": "HASSNAIN",
        "middle_name": "SAFDAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-16",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036125457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-125457",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minooka, IL

Sources for this page

Verify at the official NPI Registry.