Individual provider Active NPI

Jonathan Bickmann

  • Certified Registered Nurse Anesthetist
  • Melrose Park, IL
National Provider Identifier
1164061594
Registry record updated Jan 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209.020735 Issued in IL
Practice address
701 W North Ave
Melrose Park, IL 60160-1612
Phone
(708) 681-3200
NPI assigned
Jan 2, 2020
Last updated
Jan 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.422187 IL
Certified Registered Nurse Anesthetist 367500000X 209.020735 IL Primary

Addresses

Primary practice location

701 W North Ave
Melrose Park, IL 60160-1612

Mailing address

1247 W Madison St Unit 206
Chicago, IL 60607-0800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210603001852 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537597539 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Rush Medical College of Rush University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Medical GroupGroup PAC ID 8820277015, 191 clinicians
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000

4100 Park Forest Dr
Traverse City, MI 49684-7331
Phone (231) 392-8900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
041.422187ILMDRegistered Nurse
209.020735ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Charlevoix Hospital Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2023 Accepting new patients
Munson Healthcare Charlevoix Hospital Current Accepting new patients
Munson Medical Group CurrentSince Apr 1, 2023 Accepting new patients
Munson Medical Center Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2025 Accepting new patients
Munson Healthcare Cadillac CurrentSince Apr 1, 2023 Accepting new patients
Munson Medical Group Current Accepting new patients
Munson Healthcare Cadillac Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2023 Accepting new patients
Munson Medical Center CurrentSince Feb 1, 2025 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince May 3, 2021 Accepting new patients
Munson Medical Group Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2023 Accepting new patients
Munson Healthcare Charlevoix Hospital CurrentSince Apr 1, 2023 Accepting new patients
Munson Healthcare Cadillac Past Accepting new patients

Locations

2891 Momentum Pl
Chicago, IL 60689

3775 Momentum Pl
Chicago, IL 60689

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

14700 Lake Shore Dr
Charlevoix, MI 49720
Phone (231) 547-3840

825 N Center Ave
Gaylord, MI 49735
Phone (989) 731-2100

829 N Center Ave
Ste 210
Gaylord, MI 49735
Phone (989) 731-7860

3601 W 13 Mile Rd
Royal Oak, MI 48073

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

1105 Sixth St
Ste 103
Traverse City, MI 49684
Phone (231) 935-6455

1200 Sixth St
Ste 200
Traverse City, MI 49684

4100 Park Forest Dr
Traverse City, MI 49684
Phone (231) 392-8900

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4000

Organizations & group practices 12

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": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579305600000",
    "number": "1164061594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1247 W MADISON ST UNIT 206",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606070800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601612",
            "telephone_number": "708-681-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BICKMANN",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-01-18",
        "certification_date": "2020-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.422187",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209.020735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2020; 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.