Ruperto Mayuga, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

036075687 Issued in IL

Practice address

2800 N Sheridan Rd
Suite 303
Chicago, IL 60657-6156

Phone

(773) 281-7660

Fax

(773) 281-0841

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Northwestern Medical Faculty Foundation

  • Multi-Specialty Clinic/Center
  • Carol Stream, IL
  • NPI 1346235314
  Medicare reassignment NPD
• Mayuga Medical Practice

  • Cardiovascular Disease Physician
  • Chicago, IL
  • NPI 1396789053
  NPD (past) Authorized official
• Northwestern Medical Faculty Foundation

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1417718479
  NPD
• Robert O Isaacs, M D LTD

  • Cardiovascular Disease Physician
  • Chicago, IL
  • NPI 1720305063
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1073557740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18W 163 HOLLY AVE",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "60561",
            "telephone_number": "773-281-7660",
            "fax_number": "773-281-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N SHERIDAN RD",
            "address_2": "SUITE 303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576156",
            "telephone_number": "773-281-7660",
            "fax_number": "773-281-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYUGA",
        "first_name": "RUPERTO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036075687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "01605124",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036075687",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Spencer Mays
• Tonya Mays, MSW, LCSW
• Maysoon Al Naqeeb MD SC
• Karmen D Maytum, NP
• Mayuga Medical Practice
• Valerie Visitacion Mayuga, M.D.
• Claudia Mazariegos
• Paichence Maze, LCPC
• Ajoyoi Mazerat
• Marin Clement Alix Salomon Mazeres, MD

• Cardiovascular Disease Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Cardiovascular Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.