Phanicharan Aditya Sistla, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

036.155554 Issued in IL

Practice address

1100 36TH Ave
Moline, IL 61265-7127

Phone

(309) 743-6700

NPI assigned

Jun 15, 2013

Last updated

Oct 20, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IA, 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

Specialty

Interventional Cardiology

Education

University of Massachusetts Medical School, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cardiovascular Medicine PLLCGroup PAC ID 2264334721, 50 clinicians

Mercy Specialty ClinicGroup PAC ID 3375639586, 65 clinicians

Unity HealthcareGroup PAC ID 8224931548, 65 clinicians

Trinity Medical CenterGroup PAC ID 2264337518, shared by 4 NPIs, 97 clinicians

Genesis Health SystemGroup PAC ID 6103829338, 262 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Rock Island Hospital, Rock Island, IL, CCN 140280
• Trinity - Bettendorf Hospital, Bettendorf, IA, CCN 160104
• Genesis HLTH System Dba Genesis MDL Ctr-Illini Hospital, Silvis, IL, CCN 140275
• Mercyone Clinton Medical Center Hospital, Clinton, IA, CCN 160080
• Trinity Muscatine Hospital, Muscatine, IA, CCN 160013

Merit-based Incentive Payment System (MIPS)

Final score

82.95 of 100Reported as group

Quality

70.54

Promoting interoperability

97

Improvement activities

40

Cost

75.13

Merit-based Incentive Payment System (MIPS)

Final score

88.8 of 100Reported as apm

Quality

82.54

Promoting interoperability

89.05

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

34.85 of 100Reported as group

Quality

21.4

Improvement activities

0

Cost

76.92

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: psistla1008313@direct.unitypoint.org
• Direct secure messaging: psistla48167@direct.luhs.org

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.

• Genesis Health System

  dba Genesis Medical Center - Silvis

  • General Acute Care Hospital
  • Silvis, IL
  • NPI 1427132604
  Medicare reassignment Care Compare group NPD
• Cardiovascular Medicine PLLC

  • Cardiovascular Disease Physician
  • Davenport, IA
  • NPI 1982632907

  IL

  Medicare reassignment Care Compare group NPD
• Mercy Specialty Clinic

  dba MercyOne Specialty Care

  • Multi-Specialty Clinic/Center
  • Clinton, IA
  • NPI 1386832764
  Medicare reassignment Care Compare group NPD
• Unity Healthcare

  dba Unity Physician Clinics

  • Internal Medicine Physician
  • Muscatine, IA
  • NPI 1629122742
  Medicare reassignment Care Compare group NPD
• Trinity Medical Center

  • Psychiatry Physician
  • Rock Island, IL
  • NPI 1033163829

  IA

  Medicare reassignment NPD
• Trinity Medical Center

  • Emergency Medicine Physician
  • Rock Island, IL
  • NPI 1568414134

  Internal Medicine

  Medicare reassignment NPD
• Genesis Health System

  dba Genesis Convenient Care Bettendorf

  • Clinic/Center
  • Bettendorf, IA
  • NPI 1497772008
  Medicare reassignment
• Loyola University Medical Center

  dba Foster G. McGaw Hospital

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  NPD
• Medical Associates of Clinton, Iowa P.L.C.

  • Family Medicine Physician
  • Clinton, IA
  • NPI 1841244431

  Internal Medicine

  NPD
• Mercy Specialty Clinic

  dba MercyOne Clinton North Health Plaza

  • Family Medicine Physician
  • Clinton, IA
  • NPI 1275197998
  NPD
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Unity Healthcare

  dba Unitypoint Clinic - Mulberry

  • Rural Health Clinic/Center
  • Muscatine, IA
  • NPI 1447802400
  NPD

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

• Genesis Health System

  dba Genesis Medical Center - Silvis

  • General Acute Care Hospital
  • Silvis, IL
  • NPI 1427132604
  Care Compare affiliation
• Trinity Medical Center

  dba Trinity Rock Island

  • General Acute Care Hospital
  • Rock Island, IL
  • NPI 1316047632
  Care Compare affiliation
• Mercy Medical Center-Clinton, Inc

  dba MercyOne Clinton Medical Center

  • General Acute Care Hospital
  • Clinton, IA
  • NPI 1427093962
  Care Compare affiliation
• Trinity Medical Center

  dba Trinity Bettendorf

  • General Acute Care Hospital
  • Bettendorf, IA
  • NPI 1124110820
  Care Compare affiliation
• Unity Healthcare

  dba Trinity Muscatine

  • General Acute Care Hospital
  • Muscatine, IA
  • NPI 1861444333
  Care Compare affiliation

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

{
    "created_epoch": "1371254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1720427453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 36TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612657127",
            "telephone_number": "309-743-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 36TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612657127",
            "telephone_number": "309-743-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawkins Dr Dept Of",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "52242",
            "country_code": "US",
            "telephone_number": "319-467-2000",
            "fax_number": "319-384-8955",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2160 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "708-216-5911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SISTLA",
        "first_name": "PHANICHARAN",
        "middle_name": "ADITYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-15",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "MD-43414",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "255413",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IA",
            "license": "MD-43414",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IA",
            "license": "MD-43414",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036.155554",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IA",
            "license": "MD-43414",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "phanicharan.sistlamd.p1@direct.cvmedpc.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1100 36th Ave",
            "city": "Moline",
            "state": "IL",
            "country_code": "US",
            "postal_code": "612657127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Silience Counseling Services, PLLC
• Desiree Diocson Simpao, PT
• Param Puneet Singh, M.D.
• Annette Zoe Sirek Jones, MS, CCC-SLP
• Adiba Makhammatovna Sirojeva, APRN
• Sisu Counseling Center, PLLC
• Donna J Sivertsen, RD, LDN, CDE
• Veronica Skaradzinski, MS, RDN, LDN
• Kristine Skinner, BSW, MHP
• Jessica Slover Miller, LCPC, LMHC

• Interventional Cardiology Physician in Moline, IL
• Providers in Moline, IL by specialty
• Interventional Cardiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.