Individual provider Active NPI

Domenico Ascenzio John Farina

  • Gastroenterology Physician
  • Chicago, IL
National Provider Identifier
1043665060
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036149120 Issued in IL
Practice address
259 E Erie St Ste 1600
Chicago, IL 60611-3111
Phone
(312) 695-5620
Fax
(312) 695-2729
NPI assigned
Apr 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.068463 IL
Gastroenterology Physician 207RG0100X 036149120 IL Primary

Addresses

Primary practice location

259 E Erie St Ste 1600
Chicago, IL 60611-3111

Mailing address

259 E Erie St Ste 1600
Chicago, IL 60611-3111
Phone (312) 695-5620

Other practice location 1

201 East Huron Street
Galter 3-150
Chicago, IL 60611
Phone (312) 926-2253

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
I20220701001793 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 9234415803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Northwestern University Feinberg Medical School, 2016
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 St
2300 Chic LS Med Div NW
Chicago, IL 60611-2915
Phone (312) 926-6101

Hospital & facility affiliations

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

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy55
Upper gastrointestinal (GI) endoscopy for acid reflux385

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.068463ILMDInternal Medicine Physician
036149120ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jun 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 1, 2022 Accepting new patients
Central Dupage Physician Group Internal Medicine Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

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

676 N Saint Clair St
Ste 2300
Chicago, IL 60611

676 N Saint Clair St
Ste 2330
Chicago, IL 60611
Phone (312) 503-4494

259 E Erie St
Ste 1600
Chicago, IL 60611

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

15300 West Ave
Ste 210
Orland Park, IL 60462
Phone (708) 226-2870

Organizations & group practices 3

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 6

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": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1043665060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 1600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113111",
            "telephone_number": "312-695-5620",
            "fax_number": "312-695-2729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 1600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113111",
            "telephone_number": "312-695-5620",
            "fax_number": "312-695-2729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 East Huron Street",
            "address_2": "Galter 3-150",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60611",
            "country_code": "US",
            "telephone_number": "312-926-2253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARINA",
        "first_name": "DOMENICO",
        "middle_name": "ASCENZIO JOHN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-27",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.068463",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036149120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.