Active NPI
Carmen Gnatenco, M.D.
- Internal Medicine Physician
- Oak Lawn, IL
National Provider Identifier
1043363708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036-115290
- Practice address
- 4938 W 95TH St
Oak Lawn, IL 60453-2504 - Phone
- (708) 425-4662
- Fax
- (708) 425-4692
- NPI assigned
- Jan 18, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036-115290 | IL | Primary |
Addresses
Primary practice location
4938 W 95TH St
Oak Lawn, IL 60453-2504
Mailing address
6400 W College Dr Ste 600
Palos Heights, IL 60463-1900
Phone (708) 389-3224
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871750711 | Other | IL | BCBS |
| 036115290 | Medicaid | IL |
Other names 1
- Carmen Dumitrachi
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070404000519 | IL | Practitioner - Internal Medicine | 4183728892 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
12211 S Harlem Ave
FL 2
Palos Heights, IL 60463-1471
Phone (708) 295-9399
Hospital & facility affiliations
- Palos Community Hospital Home Health Care
- Northwestern Medicine Central Dupage Hospital
- Advocate Christ Hospital & Medical Center
- Palos Community Hospital
- Advocate Good Samaritan Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 23.67 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 78.89
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-115290 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carmen Gnatenco M.D., S.C. | Internal Medicine | Current | Accepting new patients |
Locations
4938 W 95th St
Oak Lawn, IL 60453
Phone (708) 425-4662
12211 S Harlem Ave
Fl 2
Palos Heights, IL 60463
Phone (708) 295-9399
6400 W College Dr
Ste 600
Palos Heights, IL 60463
Phone (708) 389-3224
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Oak Lawn, IL
- NPI 1871750711
IL, Internal Medicine
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Oak Lawn, IL
- NPI 1548375082
Hospital
-
- General Acute Care Hospital
- Downers Grove, IL
- NPI 1578670543
Hospital
-
- General Acute Care Hospital
- Winfield, IL
- NPI 1003864810
Hospital
-
- Home Health Agency
- Lemont, IL
- NPI 1790750016
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598227200000",
"number": "1043363708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6400 W COLLEGE DR STE 600",
"city": "PALOS HEIGHTS",
"state": "IL",
"postal_code": "604631900",
"telephone_number": "708-389-3224",
"fax_number": "708-389-3587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4938 W 95TH ST",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604532504",
"telephone_number": "708-425-4662",
"fax_number": "708-425-4692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GNATENCO",
"first_name": "CARMEN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-18",
"last_updated": "2020-08-24",
"certification_date": "2020-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036-115290",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1871750711",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036115290",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CARMEN",
"last_name": "DUMITRACHI",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Oak Lawn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.