Individual provider Active NPI

Kaysha Lynne Ribao, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1194340026
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125.075391 Issued in IL
Practice address
2116 S Springfield Ave
Chicago, IL 60623-2465
Phone
(808) 383-4831
NPI assigned
Jun 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125.075391 IL Primary

Addresses

Primary practice location

2116 S Springfield Ave
Chicago, IL 60623-2465

Mailing address

2653 W Ogden Ave FL 3
Chicago, IL 60608-1647

Other practice location 1

2653 W Ogden Ave Fl 3
Chicago, IL 60608-1647
Phone (773) 522-6100

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231021000204 IL Practitioner - Family Practice 9133575566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Community Health NetworkGroup PAC ID 9537076112, 182 clinicians

Practice addresses (Care Compare)

3229 -43 W 47TH PL
Kedzie Family Health Center
Chicago, IL 60632-3011
Phone (773) 254-6044

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.075391ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Network Current Accepting new patients
Access Community Health Network CurrentSince Aug 27, 2023 Accepting new patients
Access Community Health Network CurrentSince Aug 27, 2023 Accepting new patients
Access Community Health Network Past Accepting new patients

Locations

600 W Fulton St
Ste 200
Chicago, IL 60661
Phone (312) 526-2000

2653 W Ogden Ave
Fl 3
Chicago, IL 60608
Phone (773) 257-6701

3229 W 47th Pl
#43
Chicago, IL 60632
Phone (773) 254-6044

Interoperability endpoints

  • Direct secure messaging: kribao17937@direct.achn.net

Organizations & group practices 4

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 2

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": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1194340026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2653 W OGDEN AVE FL 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 S SPRINGFIELD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606232465",
            "telephone_number": "808-383-4831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2653 W Ogden Ave Fl 3",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606081647",
            "country_code": "US",
            "telephone_number": "773-522-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIBAO",
        "first_name": "KAYSHA LYNNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.075391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.