Ushasri Koganti
Individual provider Active NPI Family Medicine Physician · Ottawa, IL
NPI 1992917009 · NPPES record last updated Mar 18, 2025
Key facts
- NPI
- 1992917009
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036096808 (IL)
- Practice address
- 1129 Columbus St
Ottawa, IL 61350-2106 - Phone
- (815) 434-2048
- NPI assigned
- May 3, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 5
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Ottawa Regional Hospital and Healthcare Center
Practice addresses (Care Compare)
1100 E Norris Dr
Ottawa, IL 61350-1604
Phone (815) 433-3100
1614 E Norris Dr
Osf Healthcare Medical Group Ottawa
Ottawa, IL 61350-3681
Phone (815) 433-1010
1640 1St Ave
Ottawa, IL 61350-9214
Phone (815) 431-9208
Hospital & facility affiliations
- Osf Healthcare Home Care
- Resilience Home Health, LLC
- Osf Saint Elizabeth MDL Ctr
- Saint Francis Medical Center
- Osf Saint Paul Medical Center
- Morris Hospital & Healthcare Centers
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Osf Healthcare - Medical Group - Ottawa South |
Rural health clinic | Contracted Managing Employee Operational/Managerial Control |
Dec 1, 2022 Dec 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070802000117 | IL | Practitioner - Family Practice | 5991896102 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036096808 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Ottawa Regional Hospital & Healthcare Center | Family Medicine | Current |
Accepting new patients |
| Ottawa Regional Hospital & Healthcare Center | Current |
Accepting new patients | |
| Osf Multi-Specialty Group | Current |
Accepting new patients | |
| Ottawa Regional Hospital & Healthcare Center | Past | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
1614 E Norris Dr
Ottawa, IL 61350
Phone (815) 433-1010
1209 Starfire Dr
Ste 3
Ottawa, IL 61350
Phone (815) 433-3745
1050 E Norris Dr
Ste 3A
Ottawa, IL 61350
Phone (815) 431-5746
1640 1st Ave
Ottawa, IL 61350
Phone (815) 431-9208
1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036096808 | IL | Yes |
Addresses
Primary practice location
1129 Columbus St
Ottawa, IL 61350-2106
Mailing address
1129 Columbus St
Ottawa, IL 61350-2106
Phone (815) 434-2048
Other providers in Ottawa, IL
- William Kline
- Sarah R Knobbe
- Steven C Knoderer
- Elizebeth M Knop
- Amy L Koehler
- Kokoro Counseling, LLC.
- Mallory Komater
- Donna Krenz
- Kroger Limited Partnership I
- Karen A Krolak
All providers in Ottawa, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.