Debabrata Ray, MD
Individual provider Active NPI Emergency Medicine Physician · Granite City, IL
NPI 1699861583 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1699861583
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Practice address
- 2100 Madison Ave
Granite City, IL 62040-4701 - Phone
- (618) 798-3000
- Fax
- (618) 798-3885
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Other, 1973
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Deaconess Illinois Specialty Clinic, Inc.
Practice addresses (Care Compare)
3333 W Deyoung St
Marion, IL 62959-5884
Phone (618) 998-7000
Hospital & facility affiliations
- Heartland Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 77.51 of 100
- Quality
- 49.04
- Promoting interoperability
- 95
- Improvement activities
- 40
- Cost
- 69.42
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040506001576 | IL | Practitioner - Emergency Medicine | 5799774691 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036079368 | IL | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Emergency Good Samaritan, Inc | Emergency Medicine | Current |
Accepting new patients |
| Ahs Il Medical Group LLC | Current |
Accepting new patients | |
| Deaconess Illinois Specialty Clinic, Inc. | Current |
Accepting new patients | |
| Midwest Emergency Centralia Campus Associates, Inc | Emergency Medicine | Current |
Accepting new patients |
| Deaconess Illinois Specialty Clinic, Inc. | Current |
Accepting new patients | |
| Deaconess Illinois Specialty Clinic, Inc. | Current | Accepting new patients | |
| Yates Emergency Physicians | Emergency Medicine | Past | Accepting new patients |
| Granite City Illinois Hospital Company LLC | Past | Accepting new patients |
Locations
1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870
517 N Main St
Anna, IL 62906
Phone (618) 833-2295
400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221
4273 S State Route 159
Glen Carbon, IL 62034
Phone (618) 288-2297
2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000
303 S Commercial St
Harrisburg, IL 62946
Phone (618) 767-6050
3333 W Deyoung St
Marion, IL 62959
Phone (618) 998-7020
6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095
1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600
Interoperability endpoints
- dray172@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | IL | Yes |
Addresses
Primary practice location
2100 Madison Ave
Granite City, IL 62040-4701
Mailing address
2144 Brook Hill CT
Chesterfield, MO 63017-7941
Other providers in Granite City, IL
- Danielle Aliss Rahman
- Kelsey Rahmoeller
- Jamil Rana
- Ray Medical Supply LLC
- Bridget Ray
- Jessica Dawn Ray
- Kasey Jo Reader
- Blake Reed
- Ruth Reeves
- Regeneration Orthopedics, LLC
All providers in Granite City, IL · Emergency Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.