Active NPI
Himanshu Pathak, M.D.
- Cardiovascular Disease Physician
- Springfield, IL
National Provider Identifier
1700054939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 036134886
- Practice address
- 619 E Mason St
Suite 4P57
Springfield, IL 62701-1034 - Phone
- (217) 788-0706
- Fax
- (217) 525-2535
- NPI assigned
- Feb 11, 2008
- Last updated
- Dec 6, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 036134886 | IL | Primary |
Addresses
Primary practice location
619 E Mason St
Suite 4P57
Springfield, IL 62701-1034
Mailing address
619 E Mason St
Suite 4P57
Springfield, IL 62701-1034
Phone (217) 788-0706
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35897 | Other | MAIMONIDES MEDICAL CENTER | |
| P01361174 | Other | IL | RAILROAD |
| 036134886 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prairie Cardiovascular Consultants LTD | Cardiovascular Disease | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Cardiovascular Disease Physician
- Springfield, IL
- NPI 1659539559
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575590400000",
"number": "1700054939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "619 E MASON ST",
"address_2": "SUITE 4P57",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627011034",
"telephone_number": "217-788-0706",
"fax_number": "217-525-2535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 E MASON ST",
"address_2": "SUITE 4P57",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627011034",
"telephone_number": "217-788-0706",
"fax_number": "217-525-2535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATHAK",
"first_name": "HIMANSHU",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-11",
"last_updated": "2019-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IL",
"license": "036134886",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAIMONIDES MEDICAL CENTER",
"identifier": "35897",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "P01361174",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036134886",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.