CMS-1500 Box 24J / 33a • NPI
1083966378
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
207RG0100X (CMS 10)
Board-Certified Gastroenterologist (Digestive Tract & Liver Specialist)
Box 32 Service Location & ZIP+4
15724 S ROUTE 59, SUITE 102, PLAINFIELD, IL, 60544-2795
✓ 9-Digit EDI 837 ZIP+4 (60544-2795)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1083966378 (ADVENTIST HEALTH PARTNERS, INC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1083966378 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ADVENTIST HEALTH PARTNERS, INC |
| Plain-English Specialty | Board-Certified Gastroenterologist (Digestive Tract & Liver Specialist) NUCC Code: 207RG0100X (Internal Medicine, Gastroenterology) |
| Certifying / Licensing Body | American Board of Internal Medicine — Gastroenterology |
| Practice Location Address | 15724 S ROUTE 59, SUITE 102, PLAINFIELD, IL, 60544-2795 |
| Practice Telephone / Fax | Tel: (630) 312-3330 | Fax: (815) 267-7644 |
| Administrative Mailing Address | 15724 S ROUTE 59, PLAINFIELD, IL, 60544-2795 |
| Enumeration & Last Sync | Enumerated: 2012-10-10 | CMS Record Updated: 2017-06-14 |
| Authorized Official | RUBY MANN (Director) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (207RG0100X)
What Does Taxonomy Code 207RG0100X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207RG0100X translates to:
"Board-Certified Gastroenterologist (Digestive Tract & Liver Specialist)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ADVENTIST HEALTH PARTNERS, INC)
Typical CPT / Diagnostic Procedures:- Screening & Diagnostic Colonoscopy with Polypectomy (CPT 45378–45385)
- Esophagogastroduodenoscopy / Upper GI Endoscopy (EGD — CPT 43239)
- Hepatic Elastography (FibroScan) & Fractionated Bilirubin/LFT Workup
- Internal Hemorrhoid Banding & Anorectal Diagnostic Evaluation
- Proton Pump Inhibitors (Omeprazole, Pantoprazole, Esomeprazole)
- H. pylori Quadruple & Triple Eradication Regimens
- Mesalamine & Biologic Immunomodulators (Inflammatory Bowel Disease)
- Osmotic Laxatives, Rifaximin & Ursodeoxycholic Acid
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207RC0000X — Internal Medicine, Cardiovascular DiseasePlain English: Board-Certified Cardiologist (Heart & Blood Vessel Specialist) | State: N/A | License: Verified | Primary: Secondary |
207RC0001X — Internal Medicine, Clinical Cardiac ElectrophysiologyPlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: N/A | License: Verified | Primary: Secondary |
207X00000X — Orthopaedic SurgeryPlain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon) | State: N/A | License: Verified | Primary: Secondary |
207Y00000X — OtolaryngologyPlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Otolaryngology | State: N/A | License: Verified | Primary: Secondary |
208600000X — SurgeryPlain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon) | State: N/A | License: Verified | Primary: Secondary |
207RG0100X — Internal Medicine, GastroenterologyPlain English: Board-Certified Gastroenterologist (Digestive Tract & Liver Specialist) | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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