Individual provider Active NPI

Michelle Ann Bianzon, AGPCNP

  • Nurse Practitioner
  • Naperville, IL
National Provider Identifier
1144623752
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209011801 Issued in IL
Practice address
1243 Rickert Dr
Naperville, IL 60540-0954
Phone
(630) 527-6450
NPI assigned
Sep 28, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209011801 IL Primary

Addresses

Primary practice location

1243 Rickert Dr
Naperville, IL 60540-0954

Mailing address

1243 Rickert Dr
Naperville, IL 60540-0954
Phone (630) 527-6450

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150212001947 IL Practitioner - Nurse Practitioner 4880919901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suburban Gastroenterology LTDGroup PAC ID 8628047735, 22 clinicians

Practice addresses (Care Compare)

1243 Rickert Dr
Naperville, IL 60540-0954
Phone 6305276450150

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.11 of 100Reported as group
Quality
92.94
Promoting interoperability
100
Improvement activities
40
Cost
67.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209011801ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Gastroenterology LTD CurrentSince Nov 17, 2014 Accepting new patients

Locations

39273 Treasury Ctr
Chicago, IL 60694

1243 Rickert Dr
Naperville, IL 60540
Phone (630) 303-5650

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1411862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1144623752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1243 RICKERT DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605400954",
            "telephone_number": "630-527-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1243 RICKERT DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605400954",
            "telephone_number": "630-527-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIANZON",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-28",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209011801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.