Individual provider Active NPI

Andre Marcuss Bennett

  • Certified Registered Nurse Anesthetist
  • Chicago, IL
National Provider Identifier
1043848823
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209021467 Issued in IL
Practice address
251 E Huron St
Chicago, IL 60611-2908
Phone
(312) 926-2000
NPI assigned
Mar 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209021467 IL Primary

Addresses

Primary practice location

251 E Huron St
Chicago, IL 60611-2908

Mailing address

251 E Huron St Ste 5-704
Chicago, IL 60611-2908
Phone (312) 695-0061

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200724000339 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 3072937937 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

250 E Superior
2304 Nwmff Prent WMN Hosp
Chicago, IL 60611-2914
Phone (312) 472-3660

250 E Superior St
Chicago, IL 60611-2914

251 E Huron
Chicago, IL 60611-2908

251 E Huron St
Chicago, IL 60611-2908

259 E Erie St
Chicago, IL 60611-2930
Phone (312) 503-1944

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281

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
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
209021467ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jul 15, 2020 Accepting new patients
North American Partners in Anesthesia (Illinois), LLC CurrentSince Apr 21, 2024 Accepting new patients
Windy City Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Dec 23, 2023 Accepting new patients
Windy City Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Dec 23, 2023 Accepting new patients
Apollo Medical Group of Illinois LLC Nurse Anesthetist, Certified Registered CurrentSince May 6, 2024 Accepting new patients
Northstar Anesthesia of Illinois, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 6, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 15, 2020 Accepting new patients
Central Dupage Physician Group PastSince Sep 27, 2020 Accepting new patients

Locations

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

Dept 5777
Carol Stream, IL 60122

3034 W Peterson Ave
Chicago, IL 60659
Phone (773) 973-7432

251 E Huron St
Chicago, IL 60611

10444 S Western Ave
Ste A
Chicago, IL 60643
Phone (773) 238-1126

251 E Huron St
Ste 5704
Chicago, IL 60611
Phone (312) 695-0061

21120 Washington Pkwy
Frankfort, IL 60423
Phone (815) 469-9750

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

10401 S Roberts Rd
Ste 2
Palos Hills, IL 60465
Phone (708) 430-1600

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

Organizations & group practices 8

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 1

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": "1585440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1043848823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 E HURON ST STE 5-704",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-695-0061",
            "fax_number": "312-695-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-926-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ANDRE",
        "middle_name": "MARCUSS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-29",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209021467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.