Active NPI
Phornphat Rasamimari, M.D., MPH
- Neonatal-Perinatal Medicine Physician
- Munster, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 01060038A
- Practice address
- 901 Macarthur Blvd
Neonatology Department
Munster, IN 46321-2901 - Phone
- (219) 836-2022
- NPI assigned
- Dec 27, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036-098723 | IL | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 036-098723 | IL | |
| Hospitalist Physician | 208M00000X | 01060038A | IN | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 01060038A | IN | Primary |
Addresses
Primary practice location
901 Macarthur Blvd
Neonatology Department
Munster, IN 46321-2901
Mailing address
9201 Calumet Ave
Munster, IN 46321-2807
Phone (219) 836-2022
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200510260 | Medicaid | IN | |
| 000000964820 | Other | IN | ANTHEM PROVIDER NUMBER |
| M471400271 | Other | IN | MEDICARE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | prasamimari@direct.ccprovider.org | Direct | Cook County |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-098723 | IL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cook County | Current | Accepting new patients | |
| Arnett Clinic, LLC | Current | Accepting new patients | |
| Arnett Clinic, LLC | Pediatrics | Current | Accepting new patients |
| Cook County | Current | Accepting new patients | |
| Franciscan Physician Network | Current | Accepting new patients | |
| Cook County | Pediatrics | Current | Accepting new patients |
| Franciscan Physician Network | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| Arnett Clinic, LLC | Current | Accepting new patients | |
| Mount Sinai Community Foundation | Current | Accepting new patients | |
| Iu Health Medical Group Riley Specialists, LLC | Pediatrics | Current | Accepting new patients |
| Mount Sinai Community Foundation | Current | Accepting new patients | |
| Mount Sinai Community Foundation | Pediatrics | Current | Accepting new patients |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients |
Locations
500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000
1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100
8016 Reliable Pkwy
Chicago, IL 60686
840 S Wood St
#856
Chicago, IL 60612
Phone (312) 413-1429
1501 S California Ave
#7140
Chicago, IL 60608
Phone (773) 257-4758
1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600
1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582
26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900
7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210
1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120
1201 S Main St
Crown Point, IN 46307
Phone (219) 738-2100
705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779
2600 Greenbush St
Lafayette, IN 47904
150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211
Interoperability endpoints
- prasamimari17403@uihealth.direct-ci.com
- prasamimari@direct.ccprovider.org
Organizations & group practices 15
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.
-
- Family Medicine Physician
- Indianapolis, IN
- NPI 1225327984
-
- Pediatrics Physician
- Indianapolis, IN
- NPI 1699561480
-
dba John H. Stroger, Jr. Hospital of Cook County
- General Acute Care Hospital
- Chicago, IL
- NPI 1588612832
-
dba Sinai Medical Group
- Rehabilitation Hospital
- Chicago, IL
- NPI 1376715896
-
- Anatomic Pathology Physician
- Chicago, IL
- NPI 1386863819
-
- Durable Medical Equipment & Medical Supplies
- Lafayette, IN
- NPI 1699839563
-
- Clinical Medical Laboratory
- Lafayette, IN
- NPI 1881655090
-
- Clinic/Center
- Lafayette, IN
- NPI 1992543250
-
dba Cook County Health & Hospitals System Physician Services
- Emergency Medicine Physician
- Chicago, IL
- NPI 1821385170
Pediatrics
-
dba SMG West Care Medical Center
- Family Medicine Physician
- Chicago, IL
- NPI 1891859559
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619568000000",
"number": "1821075383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9201 CALUMET AVE",
"city": "MUNSTER",
"state": "IN",
"postal_code": "463212807",
"telephone_number": "219-836-2022",
"fax_number": "219-836-0034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 MACARTHUR BLVD",
"address_2": "NEONATOLOGY DEPARTMENT",
"city": "MUNSTER",
"state": "IN",
"postal_code": "463212901",
"telephone_number": "219-836-2022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RASAMIMARI",
"first_name": "PHORNPHAT",
"credential": "M.D., MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-27",
"last_updated": "2021-04-28",
"certification_date": "2021-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036-098723",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "IL",
"license": "036-098723",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "IN",
"license": "01060038A",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "IN",
"license": "01060038A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200510260",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER NUMBER",
"identifier": "000000964820",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "M471400271",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "prasamimari@direct.ccprovider.org",
"affiliation": "Y",
"affiliationName": "Cook County",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1969 W. Ogden Ave.",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606123723",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Munster, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.