Active NPI
Severyn Yaroshevsky, MD
- Family Medicine Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036110134
- Practice address
- 8012 S Crandon
Chicago, IL 60617-1124 - Phone
- (773) 731-9000
- Fax
- (773) 731-9622
- NPI assigned
- Jul 20, 2005
- Last updated
- May 17, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036110134 | IL | Primary |
Addresses
Primary practice location
8012 S Crandon
Chicago, IL 60617-1124
Mailing address
611 S. Wells Street #2701
Chicago, IL 60607-4782
Phone (312) 493-1219
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036110134 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 97.64 of 100
- Quality
- 88.52
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 86.94
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036110134 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Shore Hospital Corporation | Family Medicine | Current | Accepting new patients |
| Louisiana State University School of Medicine in New Orleans Faculty G | Current | Accepting new patients | |
| Louisiana State University School of Medicine in New Orleans Faculty G | Current | Accepting new patients | |
| DHS/Office of Financial Services Irs/Eopc/BMRC/Eotc/Osh/Osh-P | Current | Accepting new patients | |
| Lallie Kemp Medical Ctr | Current | Accepting new patients | |
| Lallie Kemp Medical Ctr | Current | Accepting new patients |
Locations
8012 S Crandon Ave
Chicago, IL 60617
Phone (773) 356-5000
52579 Highway 51 S
Independence, LA 70443
Phone (985) 878-1349
200 W Esplanade Ave
Kenner, LA 70065
Phone (504) 464-2940
200 W Esplanade Ave
Ste 41
Kenner, LA 70065
Phone (504) 464-2940
200 W Esplanade Ave
Ste 412
Kenner, LA 70065
Phone (504) 464-2940
1542 Tulane Ave
New Orleans, LA 70112
Phone (504) 866-2741
2025 Gravier St
Fl 6
New Orleans, LA 70112
2832 Burdette St
New Orleans, LA 70125
Phone (504) 866-2741
2600 Center St NE
Salem, OR 97301
Phone (503) 945-2800
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.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1053391359
Family Medicine
-
dba Oregon State Hospital (Salem)
- Psychiatric Hospital
- Salem, OR
- NPI 1508802489
-
dba Lallie Kemp Regional Medical Center
- Critical Access Hospital
- Independence, LA
- NPI 1558303420
-
dba Lallie Kemp Regional Medical Center
- Critical Access Hospital
- Independence, LA
- NPI 1972545846
-
dba Lsu Healthcare Network
- Durable Medical Equipment & Medical Supplies
- Kenner, LA
- NPI 1316417629
-
dba LSU Healthcare Network
- Multi-Specialty Clinic/Center
- New Orleans, LA
- NPI 1477582526
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274054400000",
"number": "1205835287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 S. WELLS STREET #2701",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606074782",
"telephone_number": "312-493-1219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8012 S CRANDON",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606171124",
"telephone_number": "773-731-9000",
"fax_number": "773-731-9622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAROSHEVSKY",
"first_name": "SEVERYN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-20",
"last_updated": "2010-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036110134",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036110134",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.