Active NPI
Michael Vincent Certo, MD, MA, MM
- Pediatric Hospice and Palliative Medicine Physician
- Chicago, IL
National Provider Identifier
1114389228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Hospice and Palliative Medicine Physician
- License
- 036165540
- Practice address
- 225 E Chicago Ave
Chicago, IL 60611-2991 - Phone
- (312) 227-6833
- Fax
- (312) 227-9058
- NPI assigned
- Mar 28, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Critical Care Medicine Physician | 2080P0203X | 036165540 | IL | |
| Pediatric Hospice and Palliative Medicine Physician | 2080H0002X | 036165540 | IL | Primary |
Addresses
Primary practice location
225 E Chicago Ave
Chicago, IL 60611-2991
Mailing address
225 E Chicago Ave
Chicago, IL 60611-2991
Phone (312) 227-6833
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Hospice/Palliative Care
- Education
- Columbia University College of Physicians and Surgeons, 2016
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
225 E Chicago Ave
Chicago, IL 60611-2991
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036165540 | IL | MD | Pediatric Critical Care Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696291200000",
"number": "1114389228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 E CHICAGO AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112991",
"telephone_number": "312-227-6833",
"fax_number": "312-227-9058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 E CHICAGO AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112991",
"telephone_number": "312-227-6833",
"fax_number": "312-227-9058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CERTO",
"first_name": "MICHAEL",
"middle_name": "VINCENT",
"name_prefix": "Dr.",
"credential": "MD, MA, MM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-03-28",
"last_updated": "2023-10-03",
"certification_date": "2023-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "IL",
"license": "036165540",
"primary": false
},
{
"code": "2080H0002X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics, Hospice and Palliative Medicine",
"state": "IL",
"license": "036165540",
"primary": true
}
],
"identifiers": [],
"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 Oct 3, 2023; 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.