Individual provider Active NPI

Anthony Barraco, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1144631086
Registry record updated May 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125.064362 Issued in IL
Practice address
1500 S California Ave
Chicago, IL 60608
Phone
(773) 257-5077
NPI assigned
May 14, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.064362 IL Primary

Addresses

Primary practice location

1500 S California Ave
Chicago, IL 60608

Mailing address

2316 W Superior St
Apt 3E
Chicago, IL 60612-1232
Phone (734) 624-9820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171101000341 NY Practitioner - HospitalistPractitioner - Internal Medicine 2860768108 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crouse Health Hospital IncGroup PAC ID 9739173774, 155 clinicians

Practice addresses (Care Compare)

736 Irving Ave
Syracuse, NY 13210-1602
Phone (315) 470-7111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125.064362ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Associates of Syracuse, PC Current Accepting new patients
St. Joseph's Physician Health, P.C. Internal Medicine CurrentSince Dec 12, 2017 Accepting new patients
North Medical PC Internal Medicine Current Accepting new patients
Crouse Health Hospital, Inc. CurrentSince Sep 3, 2017 Accepting new patients
St Josephs Medical PC Internal Medicine CurrentSince Apr 4, 2018 Accepting new patients
Crouse Health Hospital Inc CurrentSince Sep 3, 2017 Accepting new patients

Locations

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

1500 N James St
Rome, NY 13440
Phone (315) 338-7000

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

104 Union Ave
Syracuse, NY 13203
Phone (315) 422-4442

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

Interoperability endpoints

  • Direct secure messaging: ajbarraco@hiemail.healtheconnections.org

Organizations & group practices 6

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

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": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400025600000",
    "number": "1144631086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2316 W SUPERIOR ST",
            "address_2": "APT 3E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121232",
            "telephone_number": "734-624-9820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60608",
            "telephone_number": "773-257-5077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRACO",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-14",
        "last_updated": "2014-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.064362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.