Individual provider Active NPI

Lubna Fatima Qasim, PA-C

  • Physician Assistant
  • Springfield, IL
National Provider Identifier
1891408068
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1025 S 6TH St
Springfield, IL 62703-2499
Phone
(217) 528-7541
NPI assigned
Jan 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1025 S 6TH St
Springfield, IL 62703-2499

Mailing address

PO Box 19248
Springfield, IL 62794-9248
Phone (217) 528-7541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MI, IN4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20231201002494 IL Practitioner - Family Practice 9234587155 Reassigns benefits to 1 organization
I20241105003081 IL Practitioner - Physician Assistant 9234587155 Reassigns benefits to 1 organization
I20260316000302 MI Practitioner - Physician Assistant 9234587155 Reassigns benefits to 1 organization
I20260410002567 IN Practitioner - Physician Assistant 9234587155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

495 Flatbush Ave
Brooklyn, NY 11225-3706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Improvement Center Current Accepting new patients
Community Health Improvement Center CurrentSince Oct 1, 2023 Accepting new patients
Community Health Improvement Center CurrentSince Oct 1, 2023 Accepting new patients
Cityblock Medical Practice, P.a. CurrentSince Oct 1, 2025 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

320 E Central Ave
Decatur, IL 62521
Phone (217) 877-4694

16115 La Salle St
South Holland, IL 60473
Phone (347) 463-5529

186 N Main St
Fl 2
Plymouth, MI 48170
Phone (248) 602-3303

Interoperability endpoints

  • Direct secure messaging: lubna.qasim.1@27775.direct.athenahealth.com
  • Direct secure messaging: lubna.qasim.1@28977.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1891408068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19248",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949248",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032499",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QASIM",
        "first_name": "LUBNA",
        "middle_name": "FATIMA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-03",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.