Elbert A Fasnacht II, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036075250 Issued in IL

Practice address

721 S Lewis LN
Carbondale, IL 62901-3344

Phone

(618) 457-4999

Fax

(618) 457-5099

NPI assigned

Jan 9, 2007

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL, HI2 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 2

Specialty

Internal Medicine

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kauai Medical ClinicGroup PAC ID 5092628479, 147 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Home Health Kauai Home health agency, Lihue, HI, CCN 127311
• Wilcox Memorial Hospital Hospital, Lihue, HI, CCN 120014

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Kauai Medical Clinic

  • Multi-Specialty Clinic/Center
  • Lihue, HI
  • NPI 1376596643
  Medicare reassignment Care Compare group NPD
• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Herrin, IL
  • NPI 1528158573
  Medicare reassignment NPD
• Rubicon Healthcare Inc

  • Family Medicine Physician
  • Carbondale, IL
  • NPI 1598645301
  NPD
• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Carbondale, IL
  • NPI 1093801797
  NPD
• Southern Illinois Hospital Services

  • Medicare Defined Swing Bed Hospital Unit
  • Murphysboro, IL
  • NPI 1639595036
  NPD
• Kauai Medical Clinic

  • Durable Medical Equipment & Medical Supplies
  • Koloa, HI
  • NPI 1871611558
  NPD
• Hospice of Southern Illinois, Inc.

  • Community Based Hospice Care Agency
  • Belleville, IL
  • NPI 1720081805
  NPD (past)
• Kapiolani Medical Center for Women & Children

  • Children's Hospital
  • Honolulu, HI
  • NPI 1043263080
  NPD (past)

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

• Stay at Home Healthcare Services, LLC

  • Home Health Agency
  • Lihue, HI
  • NPI 1144568452
  Care Compare affiliation
• Stay at Home Healthcare Services, LLC

  • Home Health Agency
  • Hilo, HI
  • NPI 1447901657
  Care Compare affiliation
• Wilcox Memorial Hospital

  • Rural Acute Care Hospital
  • Lihue, HI
  • NPI 1225113442
  Care Compare affiliation

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252540800000",
    "number": "1790834828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 S LEWIS LN",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013344",
            "telephone_number": "618-457-4999",
            "fax_number": "618-457-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 S LEWIS LN",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013344",
            "telephone_number": "618-457-4999",
            "fax_number": "618-457-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASNACHT",
        "first_name": "ELBERT",
        "middle_name": "A",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2009-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036075250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110019903",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "036075250",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mostafa Abdul-Rahman Farache, MD
• Elsie Farough
• Corrie Lynn Farris, PA-C
• Shujaa Faryad, MD
• Carolyn Fasnacht
• Renee Barnes Feather, MD
• Karla K. Fehr, PH.D.
• Fern Leaf ABA, LLC
• Angelica Fernando, DMD
• Gina Ferraro, RDH

• Internal Medicine Physician in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; 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.