CHESTNUT HEALTH OF KENTUCKY PLLC – Internal Medicine Physician, NPI 1902645518

CHESTNUT HEALTH OF KENTUCKY PLLC is a healthcare provider. based in Bedford park, Illinois. specializing in Internal Medicine Physician. The NPI Number for CHESTNUT HEALTH OF KENTUCKY PLLC is 1902645518

Main info

Organization
Name
CHESTNUT HEALTH OF KENTUCKY PLLC
NPI
1902645518
Phone
(703) 964-8199
Address
PO BOX 915
Authorized Official
MR. OMAIR SIRAJ OWNER
Enumeration Date
22 May 2024
Last Update Date
18 June 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:2State licenses:0Digital endpointsOther names

Provider Addresses for CHESTNUT HEALTH OF KENTUCKY PLLC

  • PO BOX 915

    BEDFORD PARK, IL 604990915

    Phone: (703) 964-8199

    Fax: (703) 649-6188

    Type: Mailing

  • 900 GAGEL AVE

    LOUISVILLE, KY 402164012

    Phone: (502) 368-5827

    Fax: (703) 649-6188

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-12-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20241206002916OClinic/Group PracticeKYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60499)

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Reviews

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Frequently asked questions

What number should I use to identify CHESTNUT HEALTH OF KENTUCKY PLLC for billing?
Administrative and clinical systems typically use NPI 1902645518 for CHESTNUT HEALTH OF KENTUCKY PLLC.
Is CHESTNUT HEALTH OF KENTUCKY PLLC's NPI status active today?
Active status means CHESTNUT HEALTH OF KENTUCKY PLLC's NPI record is not deactivated in the public file.
Which specialty label fits CHESTNUT HEALTH OF KENTUCKY PLLC?
NPPES ties CHESTNUT HEALTH OF KENTUCKY PLLC to Internal Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to CHESTNUT HEALTH OF KENTUCKY PLLC?
CHESTNUT HEALTH OF KENTUCKY PLLC is associated with Bedford Park, Illinois in the same public data insurers reference.
Who maintains CHESTNUT HEALTH OF KENTUCKY PLLC's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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