Individual provider Active NPI

Mehraboon S Irani, MD

  • Blood Banking & Transfusion Medicine Physician
  • Evanston, IL
National Provider Identifier
1689677148
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Blood Banking & Transfusion Medicine PhysicianTaxonomy code 207ZB0001X
License
036143963 Issued in IL
Practice address
2650 Ridge Ave.
Dept. Pathology
Evanston, IL 60201
Phone
(847) 570-2181
NPI assigned
May 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Blood Banking & Transfusion Medicine Physician 207ZB0001X 14900 NV
Blood Banking & Transfusion Medicine Physician 207ZB0001X 43214 AZ
Hematology (Pathology) Physician 207ZH0000X H2483 TX
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036143963 IL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 9376 NM
Blood Banking & Transfusion Medicine Physician 207ZB0001X 036143963 IL Primary

Addresses

Primary practice location

2650 Ridge Ave.
Dept. Pathology
Evanston, IL 60201

Mailing address

2650 Ridge Ave.
Dept. Pathology
Evanston, IL 60201
Phone (847) 570-2181

Other practice location 1

638 N 18th St
Blood Center of Wisconsin
Milwaukee, WI 53201-2178
Phone (414) 937-6347

Other identifiers 1

IdentifierTypeStateIssuer
5857MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131223000531 WI Practitioner - Pathology 9335135052 Reassigns benefits to 2 organizations
I20220217000491 IL Practitioner - Pathology 9335135052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Suite 2218a
Evanston, IL 60201-1700
Phone (847) 503-4222

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Swedish Hospital Hospital, Chicago, IL, CCN 140114
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H2483TXMDSpecialist
43214AZMDBlood Banking & Transfusion Medicine Physician
14900NVMDBlood Banking & Transfusion Medicine Physician
9376NMMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Versiti Blood Health Inc. CurrentSince Oct 18, 2013 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Jul 1, 2014 Accepting new patients
Endeavor Health Medical Group Blood Banking & Transfusion Medicine CurrentSince Dec 1, 2021 Accepting new patients
Versiti Blood Health Inc. Blood Banking & Transfusion Medicine CurrentSince Oct 18, 2013 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 1, 2021 Accepting new patients
Unm Medical Group Inc Past Accepting new patients
Assurance Drug Testing Laboratories LLC Past Accepting new patients
Labworks, LLC Past Accepting new patients
University Physician Associates Past Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

29779 Network Pl
Chicago, IL 60673

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

975 Port Washington Rd
Grafton, WI 53024
Phone (262) 329-1000

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

638 N 18th St
Milwaukee, WI 53233
Phone (414) 933-5000

240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900

36500 Aurora Dr
Summit, WI 53066
Phone (262) 434-1000

791 Summit Ave
Summit, WI 53066
Phone (262) 569-0251

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

8901 W Lincoln Ave
West Allis, WI 53227
Phone (414) 328-6000

Organizations & group practices 9

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 5

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1689677148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "DEPT. PATHOLOGY",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60201",
            "telephone_number": "847-570-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "DEPT. PATHOLOGY",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60201",
            "telephone_number": "847-570-2181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "638 N 18th St",
            "address_2": "Blood Center of Wisconsin",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532012178",
            "country_code": "US",
            "telephone_number": "414-937-6347",
            "fax_number": "414-933-6803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IRANI",
        "first_name": "MEHRABOON",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "NV",
            "license": "14900",
            "primary": false
        },
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "AZ",
            "license": "43214",
            "primary": false
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "TX",
            "license": "H2483",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036143963",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NM",
            "license": "9376",
            "primary": false
        },
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "IL",
            "license": "036143963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5857",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.