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NYA ANWANANE MD
NPI 1174217905
Family Medicine in Carbondale, IL

Active since June 05, 2023PECOS Enrolled
300 W OAK ST STE 200, CARBONDALE, IL 62901(618) 536-6621(618) 453-1102 Get Directions Write a Review

NPPES record last updated: June 5, 2023. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Nya Anwanane Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NYA ANWANANE MD (NPI 1174217905) is an individual family medicine provider in Carbondale, Illinois, licensed in Illinois (125082195) and active in the NPI registry since June 2023. He is enrolled in Medicare PECOS, is affiliated with Memorial Hospital Of Carbondale, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1174217905
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameNYA ANWANANECredential: MD
Location Address300 W OAK ST STE 200Carbondale, IL 62901-1400
Mailing Address300 W Oak StCarbondale, IL 62901-1400
Phone(618) 536-6621
Fax(618) 453-1102
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJune 5, 2023
NPPES CertifiedJune 5, 2023
✔ NPI 1174217905 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 125082195
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
300 W OAK ST STE 200, Carbondale, IL 62901
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nya Anwanane Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID143680587
PECOS Enrollment IDI20251217004120
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Memorial Hospital Of Carbondale

Acute Care Hospitals · Carbondale, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140164
Location405 W JacksonCarbondale, IL 62901 · Jackson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ASHMEET SINGH SAHNI MD
Family Medicine
300 W OAK ST STE 200
CARBONDALE, IL 62901
Jackson County (618) 536-6621
TYLER PATRICK MCKIBBEN MD
Family Medicine
300 W OAK ST STE 200
CARBONDALE, IL 62901
Jackson County (618) 536-6621
DR. BARSUN KIRKMAN MD
Family Medicine
300 W OAK ST STE 200
CARBONDALE, IL 62901
Jackson County (618) 536-6621
KEVIN IZQUIERDO
Family Medicine (Sports Medicine)
300 W OAK ST STE 200
CARBONDALE, IL 62901
Jackson County (618) 536-6621
RYAN TATE WEST DO
Family Medicine
300 W OAK ST STE 200
CARBONDALE, IL 62901
Jackson County (618) 536-6621
SIMRANDEEP SANDHU
Family Medicine
300 W OAK ST STE 200
CARBONDALE, IL 62901
Jackson County (618) 536-6621
SHREYA SRIRAM
Family Medicine
300 W OAK ST STE 200
CARBONDALE, IL 62901
Jackson County (618) 536-0221
DOIS CHARLES OGAN DO
Family Medicine
300 W OAK ST STE 200
CARBONDALE, IL 62901
Jackson County (618) 536-6621

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nya Anwanane's NPI number?

The NPI number for Nya Anwanane is 1174217905. It was assigned to this individual provider in the NPPES registry on June 5, 2023.

Where is Nya Anwanane located?

Nya Anwanane practices at 300 W Oak St Ste 200, Carbondale, IL 62901. The listed phone number is (618) 536-6621.

What is Nya Anwanane's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Nya Anwanane enrolled in Medicare?

Yes. Nya Anwanane is registered in the Medicare PECOS enrollment system.

Is Nya Anwanane affiliated with any hospitals?

According to CMS data, Nya Anwanane is affiliated with Memorial Hospital Of Carbondale.

When was this NPI record last updated?

The NPPES record for Nya Anwanane was last updated on June 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.