NPIMap

Individual provider Active NPI

Shaiba Zeenath Ansari-Ali, M.D.

  • Rheumatology Physician
  • Geneva, IL
National Provider Identifier
1932217643
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
036110832 Issued in IL
Practice address
302 Randall Rd Ste 105
Geneva, IL 60134-4219
Phone
(630) 232-2391
Fax
(630) 232-2472
NPI assigned
Aug 25, 2006
Last updated
Nov 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 036110832 IL Primary

Addresses

Primary practice location

302 Randall Rd Ste 105
Geneva, IL 60134-4219

Mailing address

302 Randall Rd Ste 105
Geneva, IL 60134-4219
Phone (630) 232-2391

Other identifiers 3

IdentifierTypeStateIssuer
206147042OtherMEDICARE PTAN (INDIVIDUAL)
036110832MedicaidIL
206147OtherMEDICARE PTAN (GROUP)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070115000084 IL Practitioner - Rheumatology 4789684846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
University of Michigan Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

302 Randall Rd
Geneva, IL 60134-4209
Phone (630) 377-7900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036110832ILMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Rheumatology CurrentSince Jan 17, 2011 Accepting new patients
Central Dupage Physician Group CurrentSince Jan 17, 2011 Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

302 Randall Rd
Geneva, IL 60134
Phone (630) 208-6775

302 Randall Rd
Ste 105
Geneva, IL 60134
Phone (630) 232-0202

302 Randall Rd
Ste 307B
Geneva, IL 60134
Phone (630) 232-2391

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

25 N Winfield Rd
Ste 201
Winfield, IL 60190
Phone (630) 933-4480

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 5

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1932217643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 RANDALL RD STE 105",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344219",
            "telephone_number": "630-232-2391",
            "fax_number": "630-232-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 RANDALL RD STE 105",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344219",
            "telephone_number": "630-232-2391",
            "fax_number": "630-232-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSARI-ALI",
        "first_name": "SHAIBA",
        "middle_name": "ZEENATH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IL",
            "license": "036110832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "206147042",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036110832",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (GROUP)",
            "identifier": "206147",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

Verify at the official NPI Registry.