Karim H Bouferrache, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085004421 Issued in IL

Practice address

375 N Wall St Ste P530
Kankakee, IL 60901-3486

Phone

(815) 932-7200

Fax

(815) 935-7874

NPI assigned

Oct 11, 2011

Last updated

Dec 14, 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 1

Addresses

Electronic endpoints 3

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riverside Health SystemGroup PAC ID 3274434717, 202 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside Medical Center Hospital, Kankakee, IL, CCN 140186

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbouferrache6790@direct.riversidehealthcare.net

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.

• Riverside Health System

  • General Practice Physician
  • Kankakee, IL
  • NPI 1417061193
  Medicare reassignment Care Compare group NPD (past)
• Advocate Health and Hospitals Corporation

  dba Advocate Medical Group

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  Medicare reassignment
• Cook County

  dba John H. Stroger, Jr. Hospital of Cook County

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1588612832
  Medicare reassignment
• Advocate Health and Hospitals Corporation

  dba Advocate Children's Hospital

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  NPD
• Advocate Health and Hospitals Corporation

  dba Advocate Good Samaritan Hospital

  • General Acute Care Hospital
  • Downers Grove, IL
  • NPI 1578670543
  NPD
• Cook County

  dba Cook County Health & Hospitals System Physician Services

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1821385170
  NPD
• Cook County

  dba Bronzeville Health Center

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1831219450
  NPD
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

• Riverside Medical Center

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1538208210
  Care Compare affiliation

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1780969634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 N WALL ST STE P530",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013486",
            "telephone_number": "815-932-7200",
            "fax_number": "815-935-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 N WALL ST STE P530",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013486",
            "telephone_number": "815-932-7200",
            "fax_number": "815-935-7874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4400 W 95th St Ste 407",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604532654",
            "country_code": "US",
            "telephone_number": "708-684-4029",
            "fax_number": "708-684-4033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUFERRACHE",
        "first_name": "KARIM",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-11",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbouferrache6790@Direct.riversidehealthcare.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "375 N Wall St Ste P530",
            "city": "Kankakee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609013486",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbouferrache380815@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4400 W 95th St Ste 407",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532654",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4400 W 95th St Ste 407",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bipin N. Bhayani M.D.,S.C.
• Jennifer Blanchette, PT
• Kaity Bobadilla, DO
• Jacob Borrelli, DO
• Katie Boudreau
• Nathan James Bowers, PTA
• Julene S. Bowley-Vogen, LCSW
• Joyce Lynne Bowman, FNP-BC
• Umaimah Boxwalla, DO
• Maria Bragg

• Physician Assistant in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.