Individual provider Active NPI

Kavitha Subramanian, M.D.

  • Infectious Disease Physician
  • Rockford, IL
National Provider Identifier
1891817441
Registry record updated Sep 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
36117270 Issued in IL
Practice address
698 Featherstone Rd
Rockford, IL 61107-6303
Phone
(815) 398-3277
Fax
(815) 484-7001
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 36117270 IL Primary

Addresses

Primary practice location

698 Featherstone Rd
Rockford, IL 61107-6303

Mailing address

698 Featherstone Rd
Rockford, IL 61107-6303
Phone (815) 398-3277

Other identifiers 1

IdentifierTypeStateIssuer
036117270MedicaidIL

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
I20070626000467 IL Practitioner - Infectious DiseasePractitioner - Internal Medicine 7214036607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

698 Featherstone Rd
Rockford, IL 61107-6303
Phone (815) 398-3277

Hospital & facility affiliations

  • Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233
  • Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36117270ILMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Infectious Diseases Associates, P.C. Infectious Disease Past Accepting new patients

Locations

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

5666 E State St
Rockford, IL 61108
Phone (815) 226-2000

698 Featherstone Rd
Rockford, IL 61107
Phone (815) 398-3277

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 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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252972800000",
    "number": "1891817441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "698 FEATHERSTONE RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076303",
            "telephone_number": "815-398-3277",
            "fax_number": "815-484-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "698 FEATHERSTONE RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076303",
            "telephone_number": "815-398-3277",
            "fax_number": "815-484-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBRAMANIAN",
        "first_name": "KAVITHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2009-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": "36117270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036117270",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.