Organization Active NPI

Nephrology Associates of Northern Illinois, LTD.

  • Nephrology Physician
  • Oak Brook, IL
National Provider Identifier
1124069182
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NEPHROLOGY ASSOCIATES OF NORTHERN ILLINOIS, LTD.
Practice address
120 W 22ND St Ste 200
Oak Brook, IL 60523-1563
Phone
(630) 575-5000
NPI assigned
Jun 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Authorized official

Name
Manish Tanna, MDNPI 1821096470
Title
President
Phone
(630) 573-5000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

120 W 22ND St Ste 200
Oak Brook, IL 60523-1563

Mailing address

120 W 22ND St
Oak Brook, IL 60523-1563
Phone (630) 573-5000

Other practice location 1

15 S McHenry Rd Fl 2
Buffalo Grove, IL 60089-6705
Phone (847) 439-8780

Other practice location 2

800 Biesterfield Rd Ste G01
Elk Grove Village, IL 60007-3372
Phone (847) 981-3680

Other practice location 3

10370 Haligus Rd Ste 103
Huntley, IL 60142-9582
Phone (847) 531-5911

Other practice location 4

901 Biesterfield Rd Ste 310
Elk Grove Village, IL 60007-7324
Phone (847) 952-9332

Other practice location 5

2701 W 68th St
Chicago, IL 60629-1813
Phone (773) 735-4884

Other practice location 6

675 W North Ave Ste 402
Melrose Park, IL 60160-1624
Phone (708) 450-4551

Other practice location 7

1345 Edwards St Ste 3
Morris, IL 60450-1692
Phone (815) 905-2209

Other practice location 8

800 Biesterfield Rd Bldg Ste 101
Elk Grove Village, IL 60007-3361
Phone (847) 427-7100

Other practice location 9

9125 S Pulaski Rd
Evergreen Park, IL 60805-1441
Phone (708) 422-7715

Other practice location 10

2850 W 95th St Ste 300
Evergreen Park, IL 60805-2741
Phone (773) 735-4884

Other practice location 11

1600 N Randall Rd Ste 135
Elgin, IL 60123-7810
Phone (847) 531-5911

Other practice location 12

412 63rd St Ste 100
Downers Grove, IL 60516-2000
Phone (331) 775-2783

Other practice location 13

910 Greenlee St Unit B
Marengo, IL 60152-8200
Phone (815) 301-1001

Other practice location 14

2055 W Army Trail Rd Ste 110N
Addison, IL 60101-1478
Phone (773) 284-9247

Other practice location 15

251 N Cass Ave Ste 100
Westmont, IL 60559-1745
Phone (630) 963-0309

Other practice location 16

390 E Congress Pkwy Ste C
Crystal Lake, IL 60014-6202
Phone (815) 301-1001

Other practice location 17

6307 S Stewart Ave Ste 210
Chicago, IL 60621-3116
Phone (773) 483-2200

Other practice location 18

13755 Cicero Ave
Crestwood, IL 60418-1824
Phone (708) 388-0499

Other practice location 19

6438 Joliet Rd Ste 203
Countryside, IL 60525-4624
Phone (708) 352-5222

Other practice location 20

16605 107th St
Orland Park, IL 60467-9016
Phone (708) 226-9860

Other practice location 21

1875 W Dempster St Ste 605
Park Ridge, IL 60068-1168
Phone (847) 439-8780

Other practice location 22

2560 Hauser Ross Dr Ste 450
Sycamore, IL 60178-3185
Phone (815) 301-1001

Other practice location 23

1475 E Belvidere Rd Ste 317
Grayslake, IL 60030-2016
Phone (847) 855-9152

Other practice location 24

1425 N Hunt Club Rd Ste 301
Gurnee, IL 60031-2639
Phone (847) 855-9152

Other practice location 25

1555 N Barrington Rd Ste 3400
Hoffman Estates, IL 60169-1023
Phone (847) 952-9332

Other practice location 26

1345 Ryan Pkwy
Algonquin, IL 60102-4530
Phone (847) 531-5911

Other practice location 27

12250 S Cicero Ave Ste 112
Alsip, IL 60803-2946
Phone (708) 371-5308

Other practice location 28

28160 W Northwest Hwy Ste 105
Lake Barrington, IL 60010-2332
Phone (815) 301-1001

Other practice location 29

2222 W Division St Ste 260
Chicago, IL 60622-2990
Phone (708) 252-5809

Other practice location 30

6948 W Windsor Ave
Berwyn, IL 60402-3335
Phone (708) 749-4617

Other practice location 31

3100 Theodore St Ste 201
Joliet, IL 60435-0605
Phone (815) 905-2209

Other practice location 32

1890 Silver Cross Blvd Ste 415
New Lenox, IL 60451-9575
Phone (815) 717-8750

Other practice location 33

1625 E 75th St Ste 328
Chicago, IL 60649-3603
Phone (773) 947-7841

Other practice location 34

601 W Golf Rd Ste 105
Mount Prospect, IL 60056-4276
Phone (847) 439-8780

Other practice location 35

2740 W Foster Ave Ste 405
Chicago, IL 60625-3532
Phone (872) 208-7619

Other practice location 36

104 S Ashland Ave
Chicago, IL 60607-2402
Phone (312) 850-8434

Other identifiers 2

IdentifierTypeStateIssuer
C30486OtherILRR-GROUP COOK
1616108OtherILBLUE CROSS BLUE SHIELD

Other names 1

  • NANI Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031208000313 IL Part B Supplier - Clinic/Group Practice 2163328675 Receives reassigned benefits from 163 practitioners
2 other NPIs on this enrollment
Practice locations: Gurnee, IL; Harvey, IL; Hinsdale, IL; Hoffman Estates, IL; Huntley, IL; Joliet, IL; La Grange Highlands, IL; Lake Barrington, IL…

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D1005883Nephrology Associates675 W North Ave, Ste 402, Melrose Park, IL 60160Certificate of waiverOct 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Nephrology Associates of Northern Illinois5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations (25 of 66)

2055 W Army Trail Rd
Ste 110E
Addison, IL 60101
Phone (773) 284-9247

2055 W Army Trail Rd
Ste 110N
Addison, IL 60101
Phone (773) 284-9247

12250 S Cicero Ave
Ste 112
Alsip, IL 60803
Phone (708) 371-5308

2010 S Arlington Heights Rd
Ste 225
Arlington Heights, IL 60005
Phone (872) 222-7830

17 W Golf Rd
Arlington Hts, IL 60005
Phone (847) 437-2188

6527 Stanley Ave
Berwyn, IL 60402

2310 York St
Ste 4A
Blue Island, IL 60406
Phone (708) 489-7940

2310 York St
#5A
Blue Island, IL 60406
Phone (708) 597-9933

2310 York St
Ste A
Blue Island, IL 60406

2310 York St
Ste 3B
Blue Island, IL 60406
Phone (708) 388-0499

2310 York St
#3B
Blue Island, IL 60406
Phone (708) 388-0499

15 S McHenry Rd
Fl 2
Buffalo Grove, IL 60089
Phone (847) 439-8780

15 S McHenry Rd
Fl 3
Buffalo Grove, IL 60089
Phone (847) 212-3885

1450 Busch Pkwy
#3
Buffalo Grove, IL 60089

7721 S Western Ave
Chicago, IL 60620
Phone (773) 471-0400

2320 E 93rd St
Ste 236
Chicago, IL 60617
Phone (773) 947-7841

3134 W 76th St
Side Dialysis
Chicago, IL 60652
Phone (773) 471-2805

820 W Jackson Blvd
Chicago, IL 60607
Phone (312) 563-4134

7009 W Belmont Ave
Chicago, IL 60634
Phone (773) 348-0101

7531 S Stony Island Ave
Ste 160
Chicago, IL 60649

5509 N Cumberland Ave
Chicago, IL 60656
Phone (773) 631-8296

1835 W Harrison St
Chicago, IL 60612
Phone (312) 633-6000

1625 E 75th St
Ste 328
Chicago, IL 60649
Phone (773) 947-7841

6307 S Stewart Ave
Ste S203
Chicago, IL 60621

7531 S Stony Island Ave
#158160
Chicago, IL 60649
Phone (773) 947-7841

Practitioners & affiliated clinicians

Practitioners 187

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 187

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1124069182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231563",
            "telephone_number": "630-573-5000",
            "fax_number": "630-368-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST STE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231563",
            "telephone_number": "630-575-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 S McHenry Rd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Buffalo Grove",
            "state": "IL",
            "postal_code": "600896705",
            "country_code": "US",
            "telephone_number": "847-439-8780",
            "fax_number": "847-439-8940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Biesterfield Rd Ste G01",
            "address_purpose": "LOCATION",
            "city": "Elk Grove Village",
            "state": "IL",
            "postal_code": "600073372",
            "country_code": "US",
            "telephone_number": "847-981-3680",
            "fax_number": "847-956-5122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10370 Haligus Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601429582",
            "country_code": "US",
            "telephone_number": "847-531-5911",
            "fax_number": "847-531-5922",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 Biesterfield Rd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Elk Grove Village",
            "state": "IL",
            "postal_code": "600077324",
            "country_code": "US",
            "telephone_number": "847-952-9332",
            "fax_number": "847-952-9338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2701 W 68th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606291813",
            "country_code": "US",
            "telephone_number": "773-735-4884",
            "fax_number": "773-735-2625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "675 W North Ave Ste 402",
            "address_purpose": "LOCATION",
            "city": "Melrose Park",
            "state": "IL",
            "postal_code": "601601624",
            "country_code": "US",
            "telephone_number": "708-450-4551",
            "fax_number": "708-681-9711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1345 Edwards St Ste 3",
            "address_purpose": "LOCATION",
            "city": "Morris",
            "state": "IL",
            "postal_code": "604501692",
            "country_code": "US",
            "telephone_number": "815-905-2209",
            "fax_number": "815-744-5428",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Biesterfield Rd Bldg Ste 101",
            "address_purpose": "LOCATION",
            "city": "Elk Grove Village",
            "state": "IL",
            "postal_code": "600073361",
            "country_code": "US",
            "telephone_number": "847-427-7100",
            "fax_number": "847-981-6050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9125 S Pulaski Rd",
            "address_purpose": "LOCATION",
            "city": "Evergreen Park",
            "state": "IL",
            "postal_code": "608051441",
            "country_code": "US",
            "telephone_number": "708-422-7715",
            "fax_number": "708-422-7816",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2850 W 95th St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Evergreen Park",
            "state": "IL",
            "postal_code": "608052741",
            "country_code": "US",
            "telephone_number": "773-735-4884",
            "fax_number": "773-735-2625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 N Randall Rd Ste 135",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601237810",
            "country_code": "US",
            "telephone_number": "847-531-5911",
            "fax_number": "847-531-5922",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "412 63rd St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Downers Grove",
            "state": "IL",
            "postal_code": "605162000",
            "country_code": "US",
            "telephone_number": "331-775-2783",
            "fax_number": "866-399-1492",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "910 Greenlee St Unit B",
            "address_purpose": "LOCATION",
            "city": "Marengo",
            "state": "IL",
            "postal_code": "601528200",
            "country_code": "US",
            "telephone_number": "815-301-1001",
            "fax_number": "815-301-1002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2055 W Army Trail Rd Ste 110N",
            "address_purpose": "LOCATION",
            "city": "Addison",
            "state": "IL",
            "postal_code": "601011478",
            "country_code": "US",
            "telephone_number": "773-284-9247",
            "fax_number": "630-773-2849",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "251 N Cass Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Westmont",
            "state": "IL",
            "postal_code": "605591745",
            "country_code": "US",
            "telephone_number": "630-963-0309",
            "fax_number": "855-223-1723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "390 E Congress Pkwy Ste C",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600146202",
            "country_code": "US",
            "telephone_number": "815-301-1001",
            "fax_number": "815-301-1002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6307 S Stewart Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606213116",
            "country_code": "US",
            "telephone_number": "773-483-2200",
            "fax_number": "773-483-2201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13755 Cicero Ave",
            "address_purpose": "LOCATION",
            "city": "Crestwood",
            "state": "IL",
            "postal_code": "604181824",
            "country_code": "US",
            "telephone_number": "708-388-0499",
            "fax_number": "708-388-0283",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6438 Joliet Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Countryside",
            "state": "IL",
            "postal_code": "605254624",
            "country_code": "US",
            "telephone_number": "708-352-5222",
            "fax_number": "866-353-5699",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16605 107th St",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "604679016",
            "country_code": "US",
            "telephone_number": "708-226-9860",
            "fax_number": "708-226-9864",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1875 W Dempster St Ste 605",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681168",
            "country_code": "US",
            "telephone_number": "847-439-8780",
            "fax_number": "847-439-8940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2560 Hauser Ross Dr Ste 450",
            "address_purpose": "LOCATION",
            "city": "Sycamore",
            "state": "IL",
            "postal_code": "601783185",
            "country_code": "US",
            "telephone_number": "815-301-1001",
            "fax_number": "815-301-1002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1475 E Belvidere Rd Ste 317",
            "address_purpose": "LOCATION",
            "city": "Grayslake",
            "state": "IL",
            "postal_code": "600302016",
            "country_code": "US",
            "telephone_number": "847-855-9152",
            "fax_number": "847-855-5215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1425 N Hunt Club Rd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Gurnee",
            "state": "IL",
            "postal_code": "600312639",
            "country_code": "US",
            "telephone_number": "847-855-9152",
            "fax_number": "847-855-5215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1555 N Barrington Rd Ste 3400",
            "address_purpose": "LOCATION",
            "city": "Hoffman Estates",
            "state": "IL",
            "postal_code": "601691023",
            "country_code": "US",
            "telephone_number": "847-952-9332",
            "fax_number": "847-952-9338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1345 Ryan Pkwy",
            "address_purpose": "LOCATION",
            "city": "Algonquin",
            "state": "IL",
            "postal_code": "601024530",
            "country_code": "US",
            "telephone_number": "847-531-5911",
            "fax_number": "847-531-5922",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12250 S Cicero Ave Ste 112",
            "address_purpose": "LOCATION",
            "city": "Alsip",
            "state": "IL",
            "postal_code": "608032946",
            "country_code": "US",
            "telephone_number": "708-371-5308",
            "fax_number": "708-371-5964",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "28160 W Northwest Hwy Ste 105",
            "address_purpose": "LOCATION",
            "city": "Lake Barrington",
            "state": "IL",
            "postal_code": "600102332",
            "country_code": "US",
            "telephone_number": "815-301-1001",
            "fax_number": "815-301-1002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 W Division St Ste 260",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606222990",
            "country_code": "US",
            "telephone_number": "708-252-5809",
            "fax_number": "630-701-7521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6948 W Windsor Ave",
            "address_purpose": "LOCATION",
            "city": "Berwyn",
            "state": "IL",
            "postal_code": "604023335",
            "country_code": "US",
            "telephone_number": "708-749-4617",
            "fax_number": "708-749-0094",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3100 Theodore St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Joliet",
            "state": "IL",
            "postal_code": "604350605",
            "country_code": "US",
            "telephone_number": "815-905-2209",
            "fax_number": "815-744-5428",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1890 Silver Cross Blvd Ste 415",
            "address_purpose": "LOCATION",
            "city": "New Lenox",
            "state": "IL",
            "postal_code": "604519575",
            "country_code": "US",
            "telephone_number": "815-717-8750",
            "fax_number": "815-717-8751",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1625 E 75th St Ste 328",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606493603",
            "country_code": "US",
            "telephone_number": "773-947-7841",
            "fax_number": "773-493-1430",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 W Golf Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Mount Prospect",
            "state": "IL",
            "postal_code": "600564276",
            "country_code": "US",
            "telephone_number": "847-439-8780",
            "fax_number": "847-439-8940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2740 W Foster Ave Ste 405",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606253532",
            "country_code": "US",
            "telephone_number": "872-208-7619",
            "fax_number": "773-506-6640",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 S Ashland Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606072402",
            "country_code": "US",
            "telephone_number": "312-850-8434",
            "fax_number": "312-766-4603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEPHROLOGY ASSOCIATES OF NORTHERN ILLINOIS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A",
        "authorized_official_last_name": "TANNA",
        "authorized_official_first_name": "MANISH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-573-5000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR-GROUP COOK",
            "identifier": "C30486",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1616108",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NANI",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "NANI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.