Active NPI
Richard Martin Hayes, M.D.
- Internal Medicine Physician
- Chicago, IL
National Provider Identifier
1104924638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036077240
- Practice address
- 4801 W Peterson Ave
#600
Chicago, IL 60646-5713 - Phone
- (773) 777-0078
- Fax
- (773) 777-0474
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036077240 | IL | Primary |
Addresses
Primary practice location
4801 W Peterson Ave
#600
Chicago, IL 60646-5713
Mailing address
4801 W Peterson Ave
#600
Chicago, IL 60646-5713
Phone (773) 777-0078
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31603102 | Other | IL | BC/BS |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100604000972 | IL | Practitioner - Internal Medicine | 0042340887 | Practice locations: Chicago, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
4801 W Peterson Ave
Chicago, IL 60646-5728
Phone (773) 777-0078
Hospital & facility affiliations
- Advocate Lutheran General Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036077240 | IL | MD | Internal Medicine Physician |
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Park Ridge, IL
- NPI 1164539730
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265241600000",
"number": "1104924638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4801 W PETERSON AVE",
"address_2": "#600",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606465713",
"telephone_number": "773-777-0078",
"fax_number": "773-777-0474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 W PETERSON AVE",
"address_2": "#600",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606465713",
"telephone_number": "773-777-0078",
"fax_number": "773-777-0474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYES",
"first_name": "RICHARD",
"middle_name": "MARTIN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2010-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036077240",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "31603102",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
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 Feb 4, 2010; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.