Individual provider Active NPI

Chinomso Mordi, M.D

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1740501485
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-133512 Issued in IL
Practice address
1347 N Western Ave
Chicago, IL 60622-2924
Phone
(773) 865-9154
NPI assigned
Jun 17, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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 036-133512 IL Primary

Addresses

Primary practice location

1347 N Western Ave
Chicago, IL 60622-2924

Mailing address

8475 Green Alder CT
Las Vegas, NV 89113-3679

Other names 1

  • Chinomso David Mordi Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NV, SC3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20130820000397 IL Practitioner - Internal MedicinePractitioner - Hospitalist 4587806625 Reassigns benefits to 1 organization
I20181119002504 NV Practitioner - HospitalistPractitioner - Internal Medicine 4587806625 Reassigns benefits to 3 organizations
I20240618002183 SC Practitioner - Internal Medicine 4587806625 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
98.01 of 100Reported as apm
Quality
84.78
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17873NVMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
036-133512ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Illinois, LLC Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients
Northern Nevada Medical Group, LLC Internal Medicine CurrentSince Oct 15, 2024 Accepting new patients
Saint Mary'S Medical Group Inc CurrentSince May 22, 2022 Accepting new patients
Bessler MD, PLLC Internal Medicine CurrentSince Oct 1, 2019 Accepting new patients
Saint Marys Urgent Care LLC Current Accepting new patients
Rabessler MD PC Internal Medicine CurrentSince Oct 1, 2019 Accepting new patients
Southeastern Hospitalist Services PC Internal Medicine CurrentSince Jun 1, 2024 Accepting new patients
Saint Marys Medical Group Inc. CurrentSince May 22, 2022 Accepting new patients

Locations

1801 W Olympic Blvd
#1461
Pasadena, CA 91199

1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227

20201 Crawford Ave
Olympia Flds, IL 60461
Phone (708) 503-3857

1401 E State St
Rockford, IL 61104
Phone (815) 489-4267

801 E Williams Ave
Fallon, NV 89406
Phone (775) 423-0310

102 E Lake Mead Pkwy
Henderson, NV 89015
Phone (701) 564-2622

18653 Wedge Pkwy
Ste 110
Reno, NV 89511
Phone (775) 352-7201

235 W 6th St
Reno, NV 89503
Phone (775) 746-3202

2385 E Prater Way
Ste 205
Sparks, NV 89434
Phone (775) 356-4888

2375 E Prater Way
Sparks, NV 89434
Phone (775) 331-7000

1000 Wellness Way
Fort Mill, SC 29715
Phone (803) 329-1234

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

222 Herlong Ave S
Rock Hill, SC 29732
Phone (803) 324-1950

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: dmordi1505187@nychhc.direct-ci.com

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1740501485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8475 GREEN ALDER CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891133679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1347 N WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222924",
            "telephone_number": "773-865-9154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORDI",
        "first_name": "CHINOMSO",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-17",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-133512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHINOMSO",
            "last_name": "MORDI",
            "middle_name": "DAVID",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.