Individual provider Active NPI

Amar Nath Mukerji, MD, MS

  • Colon & Rectal Surgery Physician
  • Marion, IL
National Provider Identifier
1750624045
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
036.145493 Issued in IL
Practice address
3331 W Deyoung St Ste 305
Marion, IL 62959
Phone
(618) 998-7155
NPI assigned
Apr 4, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036.145493 IL
Colon & Rectal Surgery Physician 208C00000X 036.145493 IL Primary

Addresses

Primary practice location

3331 W Deyoung St Ste 305
Marion, IL 62959

Mailing address

3331 W Deyoung St Ste 305
Marion, IL 62959-5898
Phone (618) 998-7155

Other practice location 1

1650 Selwyn Ave
Room 4A
Bronx, NY 10457-7626
Phone (718) 960-1216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190815000119 IL Practitioner - General Surgery 7214264175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3331 W Deyoung St
Marion, IL 62959-5896
Phone (618) 998-7600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.51 of 100Reported as group
Quality
49.04
Promoting interoperability
95
Improvement activities
40
Cost
69.42

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy80
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.145493ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Illinois Specialty Clinic, Inc. Surgery CurrentSince Jan 14, 2023 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. CurrentSince Jan 14, 2023 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. Surgery Current Accepting new patients
Heartland Rural Healthcare, LLC Past Accepting new patients
Bronxcare Health System Past Accepting new patients
Deaconess Illinois Clinic, Inc Past Accepting new patients

Locations

303 S Commercial St
Harrisburg, IL 62946
Phone (618) 767-6050

3333 W Deyoung St
Marion, IL 62959
Phone (618) 998-7020

3333 W Deyoung St
Ste 205
Marion, IL 62959
Phone (618) 998-1161

3331 W Deyoung St
Marion, IL 62959
Phone (618) 985-9140

3331 W Deyoung St
Ste 305
Marion, IL 62959
Phone (618) 998-7089

209 Crossroads Pl
Mount Vernon, IL 62864
Phone (618) 242-4554

4113 S Water Tower Pl
Mount Vernon, IL 62864
Phone (618) 241-9071

509 Hamacher St
Waterloo, IL 62298
Phone (618) 939-3939

Interoperability endpoints

  • Direct secure messaging: amukerji@yourcarecommunity.org
  • Direct secure messaging: amukerji416650@direct.deaconess.com
  • Direct secure messaging: amar.mukerji.1@27782.direct.athenahealth.com

Organizations & group practices 6

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1750624045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3331 W DEYOUNG ST STE 305",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595898",
            "telephone_number": "618-998-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3331 W DEYOUNG ST STE 305",
            "city": "MARION",
            "state": "IL",
            "postal_code": "62959",
            "telephone_number": "618-998-7155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Selwyn Ave",
            "address_2": "Room 4A",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104577626",
            "country_code": "US",
            "telephone_number": "718-960-1216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUKERJI",
        "first_name": "AMAR",
        "middle_name": "NATH",
        "name_prefix": "Dr.",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-04",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036.145493",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "IL",
            "license": "036.145493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

Verify at the official NPI Registry.