Dhana L Ganesan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036094637 Issued in IL

Practice address

7357 North Ave
River Forest, IL 60305-1230

Phone

(708) 405-6200

Fax

(708) 405-6223

NPI assigned

Jul 13, 2006

Last updated

Nov 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Internal Medicine

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment Care Compare group NPD
• Dhanalakshmi P Ganesan MD, SC

  dba Grand Medical Center

  • Non-Pharmacy Dispensing Site
  • River Forest, IL
  • NPI 1093080640
  NPD (past) Authorized official
• Dhanalakshmi P. Ganesan M.D.S.C

  • Internal Medicine Physician
  • River Forest, IL
  • NPI 1144382201
  Authorized official Same address or phone
• Dhanalakshmi P. Ganesan MD SC

  dba Grand-Dupage Clinic

  • Health Service Clinic/Center
  • River Forest, IL
  • NPI 1780904565
  Authorized official Same address or phone
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Panorama City, CA
  • NPI 1407888928
  NPD
• Midwest Pulmonary and Sleep

  • Pulmonary Disease Physician
  • Chicago, IL
  • NPI 1811182363
  NPD (past)
• Mount Sinai Community Foundation

  dba SMG West Chicago Physicians Associates

  • Internal Medicine Physician
  • Oak Park, IL
  • NPI 1215046347
  NPD (past)
• RLS Comprehensive Services

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1184642928
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1831114560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7357 NORTH AVE",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051230",
            "telephone_number": "708-405-6200",
            "fax_number": "708-405-6223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7357 NORTH AVE",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051230",
            "telephone_number": "708-405-6200",
            "fax_number": "708-405-6223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANESAN",
        "first_name": "DHANA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036094637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036094637",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "43112 N 15th St",
            "city": "LANCASTER",
            "state": "CA",
            "country_code": "US",
            "postal_code": "935346219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James G Frazier, D.M.D., M.S.
• Fresenius Medical Care River Forest, LLC (Fresenius Medical Care River Forest)
• Elizabeth Morick Friedman, PH.D.
• Anke Fronz, PTA
• Gabriela Zapata Alma Inc.
• Marlem Garcia, MSW, LSW
• Garden Health Group LLC
• Carol Gerson, MD
• Victoria Ghilardi, LAT, ATC
• Alison Gill, OD

• Internal Medicine Physician in River Forest, IL
• Providers in River Forest, 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 Nov 29, 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.
• 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.