NPIMap

Individual provider Active NPI

Philip Branshaw, MD

  • Internal Medicine Physician
  • Batavia, IL
National Provider Identifier
1730123134
Registry record updated Dec 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-094251 Issued in IL
Practice address
1180 W Wilson St
Ste E
Batavia, IL 60510-7611
Phone
(630) 879-5700
NPI assigned
Jun 15, 2006
Last updated
Dec 4, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2009

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 036-094251 IL Primary

Addresses

Primary practice location

1180 W Wilson St
Ste E
Batavia, IL 60510-7611

Mailing address

1180 W Wilson St
Ste E
Batavia, IL 60510-7611
Phone (630) 879-5700

Other identifiers 1

IdentifierTypeStateIssuer
036094251MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050211000530 IL Practitioner - Internal Medicine 4385545664 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Northwestern University Feinberg Medical School, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fox Valley Medical Associates, LTD.Group PAC ID 4183525454, 14 clinicians

Practice addresses (Care Compare)

1180 W Wilson St E
Batavia, IL 60510-7693
Phone (630) 879-5700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-094251ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Internal Medicine CurrentSince Mar 1, 2020 Accepting new patients
Fox Valley Medical Associates, LTD. Internal Medicine CurrentSince Aug 1, 2003 Accepting new patients
Central Dupage Physician Group CurrentSince Mar 1, 2020 Accepting new patients

Locations

2020 Ogden Ave
Ste 140
Aurora, IL 60504
Phone (630) 851-1144

1180 W Wilson St
Ste E
Batavia, IL 60510
Phone (630) 879-5700

Dept 5777
Carol Stream, IL 60122

1302 N Main St
Sandwich, IL 60548
Phone (815) 486-8484

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AAJCDD
  • Direct secure messaging: philip.branshaw@fvma.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Asbury Gardens Nursing and RehabilitationNorth Aurora, IL, CCN 146170 Skilled nursing facility W-2 Managing Employee
Adp of the SNF		 Mar 13, 2018
Jan 6, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259884800000",
    "number": "1730123134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 W WILSON ST",
            "address_2": "STE E",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605107611",
            "telephone_number": "630-879-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 W WILSON ST",
            "address_2": "STE E",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605107611",
            "telephone_number": "630-879-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANSHAW",
        "first_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2009-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-094251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036094251",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Batavia, IL

Sources for this page

Verify at the official NPI Registry.