NPIMap

Individual provider Active NPI

Narain D Mandhan, M.D.

  • Internal Medicine Physician
  • Monticello, IL
National Provider Identifier
1730170655
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-091129 Issued in IL
Practice address
1000 Medical Center Dr
Monticello, IL 61856-2116
Phone
(217) 762-6241
Fax
(217) 762-1702
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036091129 IL
Addiction Medicine (Internal Medicine) Physician 207RA0401X 036091129 IL
Internal Medicine Physician 207R00000X 036-091129 IL Primary

Addresses

Primary practice location

1000 Medical Center Dr
Monticello, IL 61856-2116

Mailing address

1000 Medical Center Dr
Monticello, IL 61856-2116
Phone (217) 762-1701

Other identifiers 1

IdentifierTypeStateIssuer
036091129MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nmandhan@kmc.kirbymedicalcenter.net Direct

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
I20051228000257 IL Practitioner - Internal MedicinePractitioner - Addiction Medicine 7517852767 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Addiction Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kirby Medical CenterGroup PAC ID 6901791144, 80 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

1000 Medical Ctr Dr
Monticello, IL 61856-2116
Phone (217) 762-1540

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036091129ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rosecrance Inc Current Accepting new patients
Rosecrance Inc CurrentSince Mar 6, 2018 Accepting new patients
Carle Health Care Incorporated Emergency Medicine CurrentSince May 17, 2013 Accepting new patients
Rosecrance Inc CurrentSince Mar 6, 2018 Accepting new patients
Kirby Medical Center Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1801 Fox Dr
Champaign, IL 61820
Phone (217) 351-9744

837 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5530

1000 Medical Center Dr
Monticello, IL 61856
Phone (217) 762-1540

1000 Medical Center Dr
Ste A
Monticello, IL 61856

1601 University Dr
Rockford, IL 61107
Phone (815) 387-2500

1021 N Mulford Rd
Rockford, IL 61107
Phone (815) 387-5600

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

718 W Killarney St
Urbana, IL 61801
Phone (217) 328-4500

Organizations & group practices 7

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.

Hospital & facility affiliations 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1730170655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER DR",
            "city": "MONTICELLO",
            "state": "IL",
            "postal_code": "618562116",
            "telephone_number": "217-762-1701",
            "fax_number": "217-762-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER DR",
            "city": "MONTICELLO",
            "state": "IL",
            "postal_code": "618562116",
            "telephone_number": "217-762-6241",
            "fax_number": "217-762-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDHAN",
        "first_name": "NARAIN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036091129",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "IL",
            "license": "036091129",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-091129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036091129",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nmandhan@kmc.kirbymedicalcenter.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 Medical Center Dr",
            "city": "Monticello",
            "state": "IL",
            "country_code": "US",
            "postal_code": "618562116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monticello, IL

Sources for this page

Verify at the official NPI Registry.