Individual provider Active NPI

Robert A Iaffaldano, M.D.

  • Interventional Cardiology Physician
  • Palos Park, IL
National Provider Identifier
1043274145
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
036081021 Issued in IL
Practice address
13011 S 104TH Ave Ste 100
Palos Park, IL 60464-1508
Phone
(708) 274-3278
Fax
(708) 274-3299
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036081021 IL
Interventional Cardiology Physician 207RI0011X 036081021 IL Primary

Addresses

Primary practice location

13011 S 104TH Ave Ste 100
Palos Park, IL 60464-1508

Mailing address

13011 S 104TH Ave Ste 100
Palos Park, IL 60464-1508
Phone (708) 478-3600

Other practice location 1

2338 New St
Blue Island, IL 60406-2402
Phone (708) 824-1114

Other practice location 2

10260 191st St Ste 102
Mokena, IL 60448-8802
Phone (708) 478-4224

Other practice location 3

11560 S Kedzie Ave Ste 100
Merrionette Park, IL 60803-4517
Phone (708) 824-1114

Other practice location 4

11560 S Kedzie Ave Ste 102
Merrionette Park, IL 60803-4517
Phone (708) 972-7525

Other identifiers 12

IdentifierTypeStateIssuer
416810OtherILMEDICARE GROUP
01621208OtherILBLUECROSS BLUE SHIELD
236550OtherILMEDICARE GROUP
036081021MedicaidIL
060042337OtherILRAILROAD MEDICARE COOK
236551OtherILMEDICARE GROUP
CD8033OtherILRAILROAD MEDICARE GROUP PTAN NUMBER
P00265015OtherILRAILROAD MEDICARE KANKAKE
060043542OtherILRAILROAD MEDICARE WILL
1508810086OtherILGROUP NPI
CG1672OtherILRAILROAD MEDICARE GROUP PTAN NUMBER
CN2703OtherILRAILROAD MEDICARE GROUP PTAN NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address riaffaldano-sm@heartcc.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040429000876 IL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 7911809413 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Nebraska College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heart Care Centers of Illinois, S.C.Group PAC ID 6103738810, 37 clinicians

Practice addresses (Care Compare)

10260 191St St
Suite 102
Mokena, IL 60448-8802
Phone (708) 478-4224

13011 S 104TH Ave
Suite 100
Palos Park, IL 60464-1508
Phone (708) 274-3278

1900 Silver Cross Blvd
New Lenox, IL 60451-9509
Phone (815) 300-7097

3231 Euclid Ave
Suite 201
Berwyn, IL 60402-3472
Phone (708) 783-2055

333 Madison St
Joliet, IL 60435-8200
Phone 81572571333472

4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone (708) 684-5509

Heart Care Centers of Illinois SC
13011 S 104TH Avenue Suite 100
Palos Park, IL 60464-1508

Hospital & facility affiliations

  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213
  • Saint Joseph Medical Center Hospital, Joliet, IL, CCN 140007
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Leg revascularization (restoring blood flow)18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036081021ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gottlieb Community Health Services Corporation CurrentSince Aug 15, 2018 Accepting new patients
Heart Care Centers of Illinois, SC Cardiovascular Disease CurrentSince Jul 19, 2010 Accepting new patients
Premier Vascular, LLC Cardiovascular Disease CurrentSince Aug 15, 2016 Accepting new patients
Gottlieb Community Health Services Corporation CurrentSince Aug 15, 2018 Accepting new patients
Macneal Physicians Group LLC Past Accepting new patients
Uropartners, LLC Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Heart Care Centers of Illinois, SC Cardiovascular Disease Past Accepting new patients
Adventist Health Partners,Inc Past Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

3231 Euclid Ave
Ste 400
Berwyn, IL 60402
Phone (708) 478-3600

2338 New St
Blue Island, IL 60406
Phone (708) 577-5060

500 Remington Blvd
Bolingbrook, IL 60440
Phone (630) 312-5000

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

125 N La Grange Rd
La Grange, IL 60525
Phone (708) 354-4900

5101 Willow Springs Rd
Lagrange Hlds, IL 60525
Phone (708) 245-4073

11560 S Kedzie Ave
Ste 102
Merrionette Park, IL 60803
Phone (708) 972-7520

11560 S Kedzie Ave
Ste 100
Merrionette Park, IL 60803
Phone (708) 824-1114

10260 191st St
Ste 102
Mokena, IL 60448
Phone (708) 478-4224

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

13011 S 104th Ave
Ste 100
Palos Park, IL 60464
Phone (708) 274-3278

3722 Harlem Ave
Ste 101
Riverside, IL 60546
Phone (708) 783-6500

Organizations & group practices 10

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1043274145",
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        {
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            "country_name": "United States",
            "address_purpose": "MAILING",
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            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604641508",
            "telephone_number": "708-478-3600",
            "fax_number": "708-478-3552"
        },
        {
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            "fax_number": "708-274-3299"
        }
    ],
    "practiceLocations": [
        {
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            "address_purpose": "LOCATION",
            "city": "Blue Island",
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            "postal_code": "604062402",
            "country_code": "US",
            "telephone_number": "708-824-1114",
            "fax_number": "708-824-9341",
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        },
        {
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            "postal_code": "604488802",
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            "telephone_number": "708-478-4224",
            "fax_number": "708-478-4033",
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        },
        {
            "address_1": "11560 S Kedzie Ave Ste 100",
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            "country_code": "US",
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            "fax_number": "708-824-9341",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11560 S Kedzie Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Merrionette Park",
            "state": "IL",
            "postal_code": "608034517",
            "country_code": "US",
            "telephone_number": "708-972-7525",
            "fax_number": "708-972-7526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IAFFALDANO",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036081021",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
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            "primary": true
        }
    ],
    "identifiers": [
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        {
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            "identifier": "01621208",
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        {
            "code": "01",
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            "issuer": "MEDICARE GROUP",
            "identifier": "236550",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036081021",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE COOK",
            "identifier": "060042337",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "236551",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP PTAN NUMBER",
            "identifier": "CD8033",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE KANKAKE",
            "identifier": "P00265015",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE WILL",
            "identifier": "060043542",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1508810086",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP PTAN NUMBER",
            "identifier": "CG1672",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP PTAN NUMBER",
            "identifier": "CN2703",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "riaffaldano-sm@heartcc.com",
            "affiliation": "N",
            "address_1": "13011 S 104th Ave Ste 100",
            "city": "Palos Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604641508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Palos Park, IL

Sources for this page

Verify at the official NPI Registry.