NPIMap

Individual provider Active NPI

Feliks S Mavashev, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1215946603
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036101294 Issued in IL
Practice address
1007 W Lawrence Ave
Chicago, IL 60640-5017
Phone
(773) 271-1500
Fax
(773) 271-2048
NPI assigned
Aug 5, 2006
Last updated
Oct 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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 036101294 IL Primary

Addresses

Primary practice location

1007 W Lawrence Ave
Chicago, IL 60640-5017

Mailing address

994 Coventry LN
Highland Park, IL 60035-3748
Phone (773) 271-1500

Other identifiers 3

IdentifierTypeStateIssuer
01626490OtherBCBSIL
036101294OtherILIL LICENSE
036101294MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040108000470 IL Practitioner - Internal Medicine 9335048446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1007 W Lawrence Ave
Chicago, IL 60640-5017
Phone (773) 271-1500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
76.63

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036101294ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Health, LTD Internal Medicine CurrentSince Nov 1, 2003 Accepting new patients

Locations

1007 W Lawrence Ave
Chicago, IL 60640
Phone (773) 271-1500

1026 W Lawrence Ave
Chicago, IL 60640
Phone (773) 271-1500

Organizations & group practices 1

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 12

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1215946603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "994 COVENTRY LN",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353748",
            "telephone_number": "773-271-1500",
            "fax_number": "773-271-2048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 W LAWRENCE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405017",
            "telephone_number": "773-271-1500",
            "fax_number": "773-271-2048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVASHEV",
        "first_name": "FELIKS",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036101294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL",
            "identifier": "01626490",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL LICENSE",
            "identifier": "036101294",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036101294",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.