Individual provider Active NPI

Navaneet S Chailerborisuth, MD, PHD

  • Ophthalmology Physician
  • Rock Island, IL
National Provider Identifier
1811988520
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036-097565 Issued in IL
Practice address
4600 30TH St
Rock Island, IL 61201-7038
Phone
(309) 788-5524
Fax
(309) 788-9550
NPI assigned
Nov 2, 2005
Last updated
Jun 15, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 32999 IA
Ophthalmology Physician 207W00000X 036-097565 IL Primary

Addresses

Primary practice location

4600 30TH St
Rock Island, IL 61201-7038

Mailing address

4600 30TH St
Rock Island, IL 61201-7038
Phone (309) 788-5524

Other identifiers 2

IdentifierTypeStateIssuer
036097565MedicaidIL
1525816MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 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

Enrollment IDStateProvider typePAC IDDetails
I20050720001085 IL Practitioner - Ophthalmology 3173569910 Reassigns benefits to 1 organization
I20100811000247 IA Practitioner - Ophthalmology 3173569910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Chicago, Pritzker School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virdi Eye Clinic of Iowa PCGroup PAC ID 4880686567, 4 clinicians
Prem S Virdi MD PCGroup PAC ID 7113963950, 4 clinicians

Practice addresses (Care Compare)

1015 13TH Ave N
Clinton, IA 52732-3479
Phone (563) 219-8000

4600 - 30TH St
Rock Island, IL 61201-7038
Phone (309) 788-5524

4624 Progress Dr
Suite C
Davenport, IA 52807-3490
Phone (563) 359-3357

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.63 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
78.75

Merit-based Incentive Payment System (MIPS)

Final score
91.71 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
72.38

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery615

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32999IAMDOphthalmology Physician
036-097565ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Prem S Virdi MD PC Ophthalmology CurrentSince Aug 1, 2005 Accepting new patients
Virdi Eye Clinic of Iowa Ophthalmology PastSince Oct 1, 2002 Accepting new patients

Locations

2202 18th Ave
Rock Island, IL 61201
Phone (309) 788-5524

4600 30th St
Rock Island, IL 61201
Phone (309) 788-5524

Interoperability endpoints

  • Direct secure messaging: nchailerborisuth92118@direct.unitypoint.org
  • Direct secure messaging: nchailertborisuth@virdi.intellechartdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276560000000",
    "number": "1811988520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 30TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017038",
            "telephone_number": "309-788-5524",
            "fax_number": "309-788-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 30TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612017038",
            "telephone_number": "309-788-5524",
            "fax_number": "309-788-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAILERBORISUTH",
        "first_name": "NAVANEET",
        "middle_name": "S",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2010-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IA",
            "license": "32999",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036-097565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036097565",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1525816",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

Verify at the official NPI Registry.