Individual provider Active NPI

Tesfaye Solomon, M.D.

  • Family Medicine Physician
  • Champaign, IL
National Provider Identifier
1821170275
Registry record updated May 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036116876 Issued in IL
Practice address
1701 W Curtis Road
Family Medicine/Convenient Care
Champaign, IL 61822
Phone
(217) 365-6201
Fax
(217) 326-1234
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036116876 IL Primary

Addresses

Primary practice location

1701 W Curtis Road
Family Medicine/Convenient Care
Champaign, IL 61822

Mailing address

611 W. Park St.
BWPC
Urbana, IL 61801-2500
Phone (217) 383-6792

Other identifiers 2

IdentifierTypeStateIssuer
0533210001OtherILDMERC
P00352898OtherILRAILROAD

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061228000043 IL Practitioner - Family Practice 9537169461 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

1701 W Curtis Rd
Champaign, IL 61822-9678
Phone (217) 365-6200

1818 E Windsor Rd
Urbana, IL 61802-9566
Phone (217) 255-9500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036116876ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Nov 27, 2020 Accepting new patients
Carle Health Care Incorporated Family Medicine CurrentSince Apr 1, 2010 Accepting new patients
Hoopeston Community Memorial Hospital Family Medicine CurrentSince Nov 27, 2020 Accepting new patients
Carle Health Care Incorporated Past Accepting new patients

Locations

3310 Fields South Dr
Champaign, IL 61822
Phone (217) 417-2352

1701 Curtis Rd
Champaign, IL 61822
Phone (217) 365-6201

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

1818 E Windsor Rd
Urbana, IL 61802
Phone (217) 255-9646

810 W Anthony Dr
Urbana, IL 61802
Phone (217) 326-2911

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399939200000",
    "number": "1821170275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "BWPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-6792",
            "fax_number": "217-383-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W CURTIS ROAD",
            "address_2": "FAMILY MEDICINE/CONVENIENT CARE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "61822",
            "telephone_number": "217-365-6201",
            "fax_number": "217-326-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "TESFAYE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2014-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036116876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0533210001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00352898",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.