Individual provider Active NPI

Sonam Verma, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Springfield, IL
National Provider Identifier
1790181402
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
036-145838 Issued in IL
Practice address
400 N 9TH St # 4a
Springfield, IL 62702-5310
Phone
(217) 545-8000
Fax
(217) 545-2303
NPI assigned
Nov 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-145838 IL
Clinical Neurophysiology Physician 2084N0600X 036-145838 IL
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 036-145838 IL Primary

Addresses

Primary practice location

400 N 9TH St # 4a
Springfield, IL 62702-5310

Mailing address

PO Box 19661
Springfield, IL 62794-9661
Phone (217) 545-8000

Other practice location 1

2601 W Main St
Carbondale, IL 62901-1031
Phone (618) 549-5361

Other practice location 2

305 W Jackson St Ste 103
Carbondale, IL 62901-1474
Phone (618) 351-4972 ext. 65869

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address sonamverma@siusm.allscriptsdirect.net
Direct Messaging Address sverma27165@sih.direct-ci.com
Direct Messaging Address sverma27165@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220224002879 NY Practitioner - NeurologyPractitioner - Pediatric Medicine 4880993302 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-145838ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Apr 1, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai Neurology With Special Qualifications in Child Neurology CurrentSince Jul 8, 2024 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Apr 1, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Mount Sinai Hospital Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-3915

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: sverma27165@sih.direct-ci.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.

NPI Registry JSON

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1790181402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19661",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949661",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N 9TH ST # 4A",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025310",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-2303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 W Main St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011031",
            "country_code": "US",
            "telephone_number": "618-549-5361",
            "fax_number": "618-351-4878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 W Jackson St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011474",
            "country_code": "US",
            "telephone_number": "618-351-4972 x65869",
            "fax_number": "618-351-6522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERMA",
        "first_name": "SONAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-06",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-145838",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "IL",
            "license": "036-145838",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "IL",
            "license": "036-145838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sonamverma@siusm.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "400 N 9th St # 4A",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627025310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sverma27165@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2601 W Main St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sverma27165@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "305 W Jackson St Ste 103",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.