NPIMap

Individual provider Active NPI

Jolly Sobin Kuncheria

  • Family Nurse Practitioner
  • Schaumburg, IL
National Provider Identifier
1821540782
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209015180 Issued in IL
Practice address
1355 Remington Rd
Ste H
Schaumburg, IL 60173-4818
Phone
(630) 701-9009
NPI assigned
Oct 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209015180 IL Primary

Addresses

Primary practice location

1355 Remington Rd
Ste H
Schaumburg, IL 60173-4818

Mailing address

1355 Remington Rd
Ste H
Schaumburg, IL 60173-4818
Phone (630) 701-9009

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jkuncheria@direct.ccprovider.org Direct Cook County

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170208001054 IL Practitioner - Nurse Practitioner 8921381468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook CountyGroup PAC ID 2860398088, 770 clinicians

Practice addresses (Care Compare)

1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 633-7292

500 E 51St St
Chicago, IL 60615-2494
Phone (312) 572-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
74.7
Promoting interoperability
100
Improvement activities
40
Cost
85.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Sep 15, 2017 Accepting new patients
Cook County CurrentSince Sep 15, 2017 Accepting new patients
Cook County Current Accepting new patients

Locations

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

Interoperability endpoints

  • Direct secure messaging: jkuncheria@direct.ccprovider.org

Organizations & group practices 3

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 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1821540782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 REMINGTON RD",
            "address_2": "STE H",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734818",
            "telephone_number": "630-701-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 REMINGTON RD",
            "address_2": "STE H",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734818",
            "telephone_number": "630-701-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNCHERIA",
        "first_name": "JOLLY",
        "middle_name": "SOBIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkuncheria@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 Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.