Individual provider Active NPI

Ma R Difanis, NP

  • Nurse Practitioner
  • Champaign, IL
National Provider Identifier
1851337109
Registry record updated Nov 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209004432 Issued in IL
Practice address
1701 Curtis Rd
Champaign, IL 61822-9678
Phone
(217) 365-6203
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209004432 IL Primary

Addresses

Primary practice location

1701 Curtis Rd
Champaign, IL 61822-9678

Mailing address

602 W University Ave
Provider Enrollment NCW4
Urbana, IL 61801-2530
Phone (217) 383-6792

Other names 1

  • Angela Difanis Professional name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041001000937 IL Practitioner - Nurse Practitioner 2567431893 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
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

200 Lerna Rd S
Mattoon, IL 61938-9388
Phone (217) 258-5900

611 W Park St
Urbana, IL 61801-2500

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

Hospital & facility affiliations

  • Carle Foundation Hospital Hospital, Urbana, IL, CCN 140091

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209004432ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hoopeston Community Memorial Hospital CurrentSince Jan 14, 2021 Accepting new patients
Great Health Medical Afil, P.C. CurrentSince Sep 14, 2024 Accepting new patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Carle Health Care Incorporated CurrentSince Feb 20, 2012 Accepting new patients
Hoopeston Community Memorial Hospital Current Accepting new patients
F.a. Wrestler M.D., LTD Past Accepting new patients
Carle Health Care Incorporated Past Accepting new patients

Locations

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

809 W Church St
Champaign, IL 61820
Phone (217) 373-1700

311 W Fairchild St
Danville, IL 61832
Phone (217) 431-7600

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

2501 Chatham Rd
Springfield, IL 62704
Phone (312) 625-0078

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

407 Willoughby Ave
Brooklyn, NY 11205
Phone (212) 201-1252

31 Spencer St
Ste 1501
Brooklyn, NY 11205
Phone (718) 851-3700

Interoperability endpoints

  • Direct secure messaging: adifanisnp14073@carlehiedirect.net

Organizations & group practices 7

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1851337109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 W UNIVERSITY AVE",
            "address_2": "PROVIDER ENROLLMENT NCW4",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012530",
            "telephone_number": "217-383-6792",
            "fax_number": "217-326-2856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 CURTIS RD",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618229678",
            "telephone_number": "217-365-6203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIFANIS",
        "first_name": "MA",
        "middle_name": "R",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209004432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "DIFANIS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.