NPIMap

Organization Active NPI

Mount Sinai Community Foundation Dba Sinai Medical Group

  • Obstetrics Physician
  • Chicago, IL
National Provider Identifier
1104471622
Registry record updated Aug 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
Legal business name
MOUNT SINAI COMMUNITY FOUNDATION DBA SINAI MEDICAL GROUP
Practice address
645 S Central Ave FL 6
Chicago, IL 60644-5059
Phone
(773) 854-5328
Fax
(773) 854-5587
NPI assigned
Aug 2, 2019
Organization subpart
Yes
Parent organization
MOUNT SINAI COMMUNITY FOUNDATION DBA SINAI MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 2, 2019

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

Authorized official

Name
Deborah Caputo
Title
Credentialing Manager
Phone
(773) 257-2905

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VX0000X Primary

Addresses

Primary practice location

645 S Central Ave FL 6
Chicago, IL 60644-5059

Mailing address

1501 S California Ave NR 7-130
Chicago, IL 60608
Phone (773) 257-2905

Other names 1

  • SMG OB on Central Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mount Sinai Medical Gro53 organizations share this tax ID, including this one
Part of
Mount Sinai Medical Gro

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

Locations

1501 S California Ave
#7130
Chicago, IL 60608

NPI Registry JSON

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

{
    "created_epoch": "1564704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564704000000",
    "number": "1104471622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S CALIFORNIA AVE NR 7-130",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60608",
            "telephone_number": "773-257-2905",
            "fax_number": "773-257-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 S CENTRAL AVE FL 6",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606445059",
            "telephone_number": "773-854-5328",
            "fax_number": "773-854-5587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT SINAI COMMUNITY FOUNDATION DBA SINAI MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUNT SINAI COMMUNITY FOUNDATION DBA SINAI MEDICAL GROUP",
        "enumeration_date": "2019-08-02",
        "last_updated": "2019-08-02",
        "status": "A",
        "authorized_official_last_name": "CAPUTO",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "773-257-2905"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMG OB on Central",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.