Shishin Yamada, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036112458 Issued in IL

Practice address

1890 Silver Cross Blvd
Pavilion a, Suite 560
New Lenox, IL 60451-9583

Phone

(815) 714-9362

Fax

(815) 846-1777

NPI assigned

Aug 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

General Surgery

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Decatur Memorial HospitalGroup PAC ID 6204731144, 173 clinicians

CGH Medical CenterGroup PAC ID 6103723267, 199 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213
• CGH Medical Center Hospital, Sterling, IL, CCN 140043

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Silver Lining Surgeons, S.C.

  • Surgery Physician
  • New Lenox, IL
  • NPI 1245568492
  Medicare reassignment NPD Authorized official
• CGH Medical Center

  • General Acute Care Hospital
  • Sterling, IL
  • NPI 1902854623
  Medicare reassignment Care Compare group
• Decatur Memorial Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1164477725
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• CGH Medical Center

  • General Acute Care Hospital
  • Sterling, IL
  • NPI 1902854623
  Care Compare affiliation
• Silver Cross Hospital & Medical Centers

  • Rehabilitation Hospital Unit
  • New Lenox, IL
  • NPI 1003933797
  Care Compare affiliation
• Silver Cross Hospital & Medical Centers

  • General Acute Care Hospital
  • New Lenox, IL
  • NPI 1568553519
  Care Compare affiliation

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1962411793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 SILVER CROSS BLVD",
            "address_2": "STE 550",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519579",
            "telephone_number": "815-714-9362",
            "fax_number": "815-846-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 SILVER CROSS BLVD",
            "address_2": "PAVILION A, SUITE 560",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519583",
            "telephone_number": "815-714-9362",
            "fax_number": "815-846-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMADA",
        "first_name": "SHISHIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036112458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112458",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Womens Health Consultants SC
• Theresa Workman, LCSW
• Kathleen Wortel, COTA
• Larissa Wright, APRN
• Ramaraja B Yalavarthi, M.D.
• Dalsem Yang
• Shingo Yano, MD
• Hannah Shamseh Yasin
• Jong-Yoon Yi, M.D.
• Samer Yosef

• Surgery Physician in New Lenox, IL
• Providers in New Lenox, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.