Individual provider Active NPI

Orest Rostyslaw Horodysky, MD

  • Internal Medicine Physician
  • Mokena, IL
National Provider Identifier
1689749475
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036055839 Issued in IL
Practice address
21205 Owens Rd Ste 3
Mokena, IL 60448-2023
Phone
(815) 469-2123
Fax
(815) 469-2149
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036055839 IL Primary

Addresses

Primary practice location

21205 Owens Rd Ste 3
Mokena, IL 60448-2023

Mailing address

21205 Owens Rd Ste 3
Mokena, IL 60448-2023
Phone (815) 469-2123

Other identifiers 3

IdentifierTypeStateIssuer
649420OtherMEDICARE PROV NUMBER
09915014OtherILBLUE CROSS BLUE SHIELD
036055839MedicaidIL

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
I20101102001415 IL Practitioner - Internal Medicine 4981627072 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Health Service Systems, Inc Internal Medicine CurrentSince Apr 26, 2024 Accepting new patients
Health Service Systems, Inc CurrentSince Apr 26, 2024 Accepting new patients

Locations

21205 Owens Rd
Ste 3
Mokena, IL 60448
Phone (815) 469-2123

1890 Silver Cross Blvd
Ste 265
New Lenox, IL 60451
Phone (815) 727-4292

Interoperability endpoints

  • Direct secure messaging: orest.horodysky@hcsc.eclinicaldirectplus.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.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1689749475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21205 OWENS RD STE 3",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604482023",
            "telephone_number": "815-469-2123",
            "fax_number": "815-469-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21205 OWENS RD STE 3",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604482023",
            "telephone_number": "815-469-2123",
            "fax_number": "815-469-2149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORODYSKY",
        "first_name": "OREST",
        "middle_name": "ROSTYSLAW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036055839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROV NUMBER",
            "identifier": "649420",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09915014",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036055839",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mokena, IL

Sources for this page

Verify at the official NPI Registry.