Individual provider Active NPI

Bozena Ewa Scigacz, M.D.

  • Internal Medicine Physician
  • Addison, IL
National Provider Identifier
1053365577
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036107066 Issued in IL
Practice address
28 W Lake St
Suite # 2
Addison, IL 60101-2709
Phone
(630) 458-0688
Fax
(630) 458-0698
NPI assigned
May 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036107066 IL Primary

Addresses

Primary practice location

28 W Lake St
Suite # 2
Addison, IL 60101-2709

Mailing address

28 W Lake St
Suite # 2
Addison, IL 60101-2709
Phone (630) 458-0688

Other identifiers 3

IdentifierTypeStateIssuer
213586OtherILMEDICARE GROUP PTAN
K27755OtherILMEDICARE PTAN
P00313447OtherILRAILROAD MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bscigacz252107@direct.myadvocateaurora.org Direct
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ Direct

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
I20060524000078 IL Practitioner - Internal Medicine 2961413364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

28 W Lake St
Suite 2
Addison, IL 60101-2709
Phone (630) 458-0688

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036107066ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bozena Scigacz Medical Office S.C. Internal Medicine CurrentSince Oct 2, 2005 Accepting new patients

Locations

28 W Lake St
Ste 2
Addison, IL 60101
Phone (630) 458-0688

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FBGBCA/Endpoint/FBGBCA
  • FHIR API: https://fhir4.healow.com/fhir/r4/FBGBCA
  • Direct secure messaging: bscigacz252107@direct.myadvocateaurora.org

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.

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1053365577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 W LAKE ST",
            "address_2": "SUITE # 2",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601012709",
            "telephone_number": "630-458-0688",
            "fax_number": "630-458-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 W LAKE ST",
            "address_2": "SUITE # 2",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601012709",
            "telephone_number": "630-458-0688",
            "fax_number": "630-458-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCIGACZ",
        "first_name": "BOZENA",
        "middle_name": "EWA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036107066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "213586",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "K27755",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00313447",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bscigacz252107@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "28 W Lake St",
            "address_2": "Suite # 2",
            "city": "Addison",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601012709",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "28 W Lake St",
            "address_2": "Suite # 2",
            "city": "Addison",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601012709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Addison, IL

Sources for this page

Verify at the official NPI Registry.