NPIMap

Organization Active NPI

Bridgecare, Inc.

  • Geriatric Medicine (Internal Medicine) Physician
  • Des Plaines, IL
National Provider Identifier
1033507249
Registry record updated Mar 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
BRIDGECARE, INC.
Practice address
2250 E Devon Ave
Suite 333
Des Plaines, IL 60018-4511
Phone
(224) 803-2273
Fax
(224) 803-2274
NPI assigned
Dec 23, 2014
Last updated
Mar 11, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2015

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

Authorized official

Name
Hemali Shah
Title
Ceo
Phone
(224) 803-2273

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X IL
Nurse Practitioner 363L00000X IL
Geriatric Medicine (Family Medicine) Physician 207QG0300X IL
Geriatric Medicine (Internal Medicine) Physician 207RG0300X IL Primary

Addresses

Primary practice location

2250 E Devon Ave
Suite 333
Des Plaines, IL 60018-4511

Mailing address

2250 E Devon Ave
Suite 333
Des Plaines, IL 60018-4511
Phone (224) 803-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150325002497 IL Part B Supplier - Clinic/Group Practice 2769709062 Receives reassigned benefits from 16 practitioners
Practice locations: Des Plaines, IL

National Provider Directory

National Provider Directory

Locations

1645 S River Rd
Ste 2
Des Plaines, IL 60018
Phone (224) 803-2273

2250 E Devon Ave
Ste 333
Des Plaines, IL 60018
Phone (224) 803-2273

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426032000000",
    "number": "1033507249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 E DEVON AVE",
            "address_2": "SUITE 333",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600184511",
            "telephone_number": "224-803-2273",
            "fax_number": "224-803-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 E DEVON AVE",
            "address_2": "SUITE 333",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600184511",
            "telephone_number": "224-803-2273",
            "fax_number": "224-803-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGECARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-23",
        "last_updated": "2015-03-11",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "HEMALI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "224-803-2273"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.