Individual provider Active NPI

Vosit Ermatov, RSA

  • Surgical Assistant
  • Downers Grove, IL
National Provider Identifier
1942747720
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
238000530 Issued in IL
Practice address
6330 Belmont Rd Ste 5
Downers Grove, IL 60516-2126
Phone
(630) 241-1933
Fax
(832) 804-8896
NPI assigned
Jan 31, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 238000530 IL
Surgical Assistant 246ZC0007X 238000530 IL Primary

Addresses

Primary practice location

6330 Belmont Rd Ste 5
Downers Grove, IL 60516-2126

Mailing address

6330 Belmont Rd Ste 5
Downers Grove, IL 60516-2126
Phone (630) 241-1933

Other practice location 1

7324 Southwest Fwy
Suite 1550
Houston, TX 77074-2012
Phone (713) 779-9800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
238000530ILMDSurgical Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Chicagoland Surgical Assistants Inc. CurrentSince Jul 24, 2022 Accepting new patients
Allied Alpha Assistants, Inc PastSince Jul 24, 2022 Accepting new patients

Locations

6330 Belmont Rd
Ste 5
Downers Grove, IL 60516
Phone (630) 241-1933

7324 Southwest Fwy
Ste 1550
Houston, TX 77074
Phone (832) 436-4273

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1942747720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 BELMONT RD STE 5",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605162126",
            "telephone_number": "630-241-1933",
            "fax_number": "832-804-8896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 BELMONT RD STE 5",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605162126",
            "telephone_number": "630-241-1933",
            "fax_number": "832-804-8896"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7324 Southwest Fwy",
            "address_2": "Suite 1550",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770742012",
            "country_code": "US",
            "telephone_number": "713-779-9800",
            "fax_number": "713-779-9813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERMATOV",
        "first_name": "VOSIT",
        "credential": "RSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "238000530",
            "primary": false
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "IL",
            "license": "238000530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.