Individual provider Active NPI

Mary Ann Zervakis-Brent

  • Certified Registered Nurse Anesthetist
  • Chicago, IL
National Provider Identifier
1215019666
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209005895 Issued in IL
Practice address
1740 W Taylor St
3Rd Floor - 3200W, Mc515
Chicago, IL 60612-7232
Phone
(312) 996-4020
Fax
(312) 996-4019
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 041253437 IL
Certified Registered Nurse Anesthetist 367500000X 209005895 IL Primary

Addresses

Primary practice location

1740 W Taylor St
3Rd Floor - 3200W, Mc515
Chicago, IL 60612-7232

Mailing address

1740 W Taylor St
3Rd Floor - 3200W, Mc515
Chicago, IL 60612-7232
Phone (312) 996-4020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081119000658 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234299355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1740 W Taylor St
Chicago, IL 60612-7232

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041253437ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Feb 1, 2016 Accepting new patients
Board of Trustees of the University of Illinois CurrentSince Feb 1, 2016 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients

Locations

1740 W Taylor St
#3200
Chicago, IL 60612
Phone (312) 996-4021

7732 Solutions Ctr
Chicago, IL 60677

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

1740 W Taylor St
Ste 3
Chicago, IL 60612
Phone (312) 996-4020

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

Interoperability endpoints

  • Direct secure messaging: mzervakisbrent17606@uihealth.direct-ci.com

Organizations & group practices 3

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1215019666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "address_2": "3RD FLOOR - 3200W, MC515",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "312-996-4020",
            "fax_number": "312-996-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "address_2": "3RD FLOOR - 3200W, MC515",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "312-996-4020",
            "fax_number": "312-996-4019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZERVAKIS-BRENT",
        "first_name": "MARY ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "041253437",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209005895",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 26, 2016; 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.