NPIMap

Individual provider Active NPI

Maria Luisa Safar Boueri, M.D.

  • Nephrology Physician
  • Chicago, IL
National Provider Identifier
1003339482
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036.158325 Issued in IL
Practice address
676 North Saint Clair Street
Suite 1900
Chicago, IL 60611-2927
Phone
(312) 695-8900
Fax
(312) 695-7752
NPI assigned
Jul 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 272586 MA
Nephrology Physician 207RN0300X 036.158325 IL Primary

Addresses

Primary practice location

676 North Saint Clair Street
Suite 1900
Chicago, IL 60611-2927

Mailing address

676 North Saint Clair Street
Suite 1900
Chicago, IL 60611-2927
Phone (312) 695-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220304001136 IL Practitioner - NephrologyPractitioner - Internal Medicine 9739573932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

676 N Saint Clair
Arkes 1725
Chicago, IL 60611-2927
Phone (312) 695-8108

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.158325ILMDNephrology Physician
272586MAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Feb 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Feb 1, 2022 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

676 N Saint Clair St
Ste 1900
Chicago, IL 60611
Phone (312) 695-3555

676 N Saint Clair St
Ste 1725
Chicago, IL 60611
Phone (312) 664-8533

676 N Saint Clair St
Fl 19
Chicago, IL 60611
Phone (312) 695-8900

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 2

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1003339482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 NORTH SAINT CLAIR STREET",
            "address_2": "SUITE 1900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112927",
            "telephone_number": "312-695-8900",
            "fax_number": "312-695-7752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 NORTH SAINT CLAIR STREET",
            "address_2": "SUITE 1900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112927",
            "telephone_number": "312-695-8900",
            "fax_number": "312-695-7752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFAR BOUERI",
        "first_name": "MARIA",
        "middle_name": "LUISA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "272586",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036.158325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.