Individual provider Active NPI

Majid Rassouli, DO

  • Ophthalmology Physician
  • Joliet, IL
National Provider Identifier
1891749081
Registry record updated Nov 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036106380 Issued in IL
Practice address
963 N 129TH Infantry Dr
Suite 110
Joliet, IL 60435-3103
Phone
(815) 729-3777
Fax
(815) 725-9358
NPI assigned
May 20, 2006
Last updated
Nov 7, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036106380 IL Primary

Addresses

Primary practice location

963 N 129TH Infantry Dr
Suite 110
Joliet, IL 60435-3103

Mailing address

963 N 129TH Infantry Dr
Suite 110
Joliet, IL 60435-3103
Phone (815) 729-3777

Other identifiers 5

IdentifierTypeStateIssuer
CG9902OtherILRETIRED RAILROAD MEDICARE
0009919581OtherILBLUE CROSS BLUE SHIELD IL
180046167OtherILRETIRED RAILROAD MEDICARE
036106380MedicaidIL
180046167-GRP CG9902OtherILRR MEDICARE

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
I20050615000597 IL Practitioner - Ophthalmology 9436193919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Michigan State University College of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eligijus P Lelis MD and Associates, SCGroup PAC ID 5890736102, 6 clinicians

Practice addresses (Care Compare)

963 N 129TH Infantry Dr
Suite 110
Joliet, IL 60435-3103
Phone (815) 725-9377

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery573

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036106380ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eligijus P Lelis MD & Associates, SC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mrassouli@eplmvp.intellechartdirect.net

Organizations & group practices 2

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.

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320624000000",
    "number": "1891749081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "963 N 129TH INFANTRY DR",
            "address_2": "SUITE 110",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604353103",
            "telephone_number": "815-729-3777",
            "fax_number": "815-725-9358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "963 N 129TH INFANTRY DR",
            "address_2": "SUITE 110",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604353103",
            "telephone_number": "815-729-3777",
            "fax_number": "815-725-9358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASSOULI",
        "first_name": "MAJID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2011-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036106380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RETIRED RAILROAD MEDICARE",
            "identifier": "CG9902",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "0009919581",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RETIRED RAILROAD MEDICARE",
            "identifier": "180046167",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036106380",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "180046167-GRP CG9902",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.