Dany Mamou, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301100135 Issued in MI

Practice address

1717 E Chicago Rd
Sturgis, MI 49091-8524

Phone

(269) 659-6747

Fax

(269) 659-6746

NPI assigned

Jul 31, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Family Practice

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lyfe Home Health Home health agency, Morton Grove, IL, CCN 148044
• Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252
• Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223
• Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
• Swedish Hospital Hospital, Chicago, IL, CCN 140114

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25060/brand/1/csg/1/fhir/r4
• Direct secure messaging: dany.mamou.1@25060.direct.athenahealth.com
• FHIR API: https://epicprdproxy.nch.org/prd-fhir/api/FHIR/R4

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.

• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882
  Medicare reassignment Care Compare group NPD
• Ninva Medical Group LLC

  • Family Medicine Physician
  • Niles, IL
  • NPI 1841963881
  Medicare reassignment NPD Authorized official
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Elgin, IL
  • NPI 1912283110
  Medicare reassignment NPD
• Mercy Health System Corporation

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603

  IL

  Medicare reassignment NPD
• Northwest Community Health Services Inc

  • Internal Medicine Physician
  • Arlington Heights, IL
  • NPI 1134433154

  Family Medicine

  Medicare reassignment NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Kankakee, IL
  • NPI 1689199614
  NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Springfield, IL
  • NPI 1871360297
  NPD
• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD
• Mercy Health System Corporation

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550
  NPD
• Northwest Community Health Services Inc

  • Obstetrics Physician
  • Arlington Heights, IL
  • NPI 1467057513
  NPD
• Northwest Community Healthcare

  • Dental Clinic/Center
  • Arlington Heights, IL
  • NPI 1386815231
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Park Ridge, IL
  • NPI 1164539730
  Care Compare affiliation
• Endeavor Health Clinical Operations

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1184670549
  Care Compare affiliation
• Four Seasons Home Healthcare, Inc.

  • Home Health Registered Nurse
  • Morton Grove, IL
  • NPI 1194808402

  Home health agency

  Care Compare affiliation
• Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1578932869
  Care Compare affiliation
• Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1770531600
  Care Compare affiliation
• Swedish Covenant Health

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1831151257
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1679704100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 S MCHENRY RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600896705",
            "telephone_number": "847-459-6100",
            "fax_number": "847-541-4857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 E CHICAGO RD",
            "city": "STURGIS",
            "state": "MI",
            "postal_code": "490918524",
            "telephone_number": "269-659-6747",
            "fax_number": "269-659-6746"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 S McHenry Rd",
            "address_purpose": "LOCATION",
            "city": "Buffalo Grove",
            "state": "IL",
            "postal_code": "60089",
            "country_code": "US",
            "telephone_number": "847-459-6100",
            "fax_number": "847-541-4857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAMOU",
        "first_name": "DANY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-31",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036142021",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301100135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036142021",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmamou105082@direct.nch.org",
            "affiliation": "N",
            "address_1": "15 S McHenry Rd",
            "city": "Buffalo Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Medicine Physician in Sturgis, MI
• Providers in Sturgis, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.