Individual provider Active NPI

Michael Warren

  • Pain Medicine (Anesthesiology) Physician
  • Chicago, IL
National Provider Identifier
1093138075
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
MD468986 Issued in PA
Practice address
1740 W Taylor St
Chicago, IL 60612-7232
Phone
(866) 600-2273
NPI assigned
Jan 28, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 125067754 IL
Student in an Organized Health Care Education/Training Program 390200000X
Pain Medicine (Anesthesiology) Physician 207LP2900X MD468986 PA Primary

Addresses

Primary practice location

1740 W Taylor St
Chicago, IL 60612-7232

Mailing address

1701 W Washington Blvd
Apt 1
Chicago, IL 60612-2637
Phone (312) 320-3809

Other practice location 1

1740 W Taylor St
Chicago, IL 60612-7232
Phone (866) 600-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20210325000749 MI Practitioner - Pain Management 2860787488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center SaultGroup PAC ID 7315936481, 101 clinicians

Practice addresses (Care Compare)

146 W Spruce St
Mymichigan Neurology
Sault Sainte Marie, MI 49783-1912
Phone (906) 253-0113

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD468986PAMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Conemaugh Physician Practices LLC Current Accepting new patients
DLP Conemaugh Physician Practices LLC CurrentSince Nov 6, 2019 Accepting new patients
Mymichigan Medical Center Sault Anesthesiology CurrentSince May 24, 2021 Accepting new patients
DLP Conemaugh Physician Practices LLC CurrentSince Nov 6, 2019 Accepting new patients
Mymichigan Medical Center Sault CurrentSince May 24, 2021 Accepting new patients
Windber Hospital, Inc. Anesthesiology Past Accepting new patients

Locations

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

500 Osborn Blvd
Sault South Marie, MI 49783
Phone (906) 635-4350

146 W Spruce St
Sault South Marie, MI 49783
Phone (906) 253-2770

1450 Scalp Ave
Johnstown, PA 15904
Phone (814) 266-1189

1450 Scalp Ave
Ste 2100
Johnstown, PA 15904
Phone (814) 269-5211

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: mwarren143499@mymichiganhealth.midirect.net

Organizations & group practices 7

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": "1390867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1093138075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W WASHINGTON BLVD",
            "address_2": "APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122637",
            "telephone_number": "312-320-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "866-600-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1740 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606127232",
            "country_code": "US",
            "telephone_number": "866-600-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARREN",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-28",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "125067754",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "PA",
            "license": "MD468986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.