Individual provider Active NPI

Stanley Bialowas, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1063518744
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036071723 Issued in IL
Practice address
3902 W Diversey Ave
Chicago, IL 60647-1021
Phone
(773) 772-5610
Fax
(773) 278-4211
NPI assigned
Sep 16, 2006
Last updated
Aug 28, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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 036071723 IL Primary
General Practice Physician 208D00000X 036071723 IL

Addresses

Primary practice location

3902 W Diversey Ave
Chicago, IL 60647-1021

Mailing address

3902 W Diversey Ave
Chicago, IL 60647-1021
Phone (773) 772-5610

Other identifiers 2

IdentifierTypeStateIssuer
0031601918OtherBCBS IL
036071723MedicaidIL

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
I20101118001324 IL Practitioner - Internal MedicinePractitioner - Hematology 7719173533 Reassigns benefits to 1 organization
Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hematology
Education
Other, 1979
Medicare assignment
May accept Medicare assignment
Group practices
Housecalls Done Wright LTDGroup PAC ID 5092148387, 8 clinicians

Practice addresses (Care Compare)

4021 W 63Rd St
Unit C
Chicago, IL 60629-4642
Phone (773) 750-2571

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.69 of 100Reported as group
Quality
87.19
Promoting interoperability
86
Improvement activities
40
Cost
40.12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036071723ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Housecalls Done Wright LTD Internal Medicine CurrentSince Oct 6, 2019 Accepting new patients
Aurora Nuclear Medicine Service LTD Past Accepting new patients
Humboldt Park Health Internal Medicine Past Accepting new patients

Locations

4021 W 63rd St
Ste C
Chicago, IL 60629
Phone (312) 504-3277

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4021/brand/1/csg/1/fhir/r4
  • Direct secure messaging: stanley.bialowas.2@4021.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1063518744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3902 W DIVERSEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471021",
            "telephone_number": "773-772-5610",
            "fax_number": "773-278-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3902 W DIVERSEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471021",
            "telephone_number": "773-772-5610",
            "fax_number": "773-278-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIALOWAS",
        "first_name": "STANLEY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036071723",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036071723",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL",
            "identifier": "0031601918",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036071723",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.