Individual provider Active NPI

John J Stavrakos, M.D.

  • Internal Medicine Physician
  • Deerfield, IL
National Provider Identifier
1215966684
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36098718 Issued in IL
Practice address
720 Osterman Ave
Suite 103
Deerfield, IL 60015-4471
Phone
(847) 945-3030
Fax
(847) 945-3033
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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 36098718 IL Primary

Addresses

Primary practice location

720 Osterman Ave
Suite 103
Deerfield, IL 60015-4471

Mailing address

720 Osterman Ave
Ste 103
Deerfield, IL 60015-4339
Phone (847) 945-3335

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
I20101027001341 IL Practitioner - Internal Medicine 5294929808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Deerfield Medical Associates,S.C.Group PAC ID 4880887272, 2 clinicians

Practice addresses (Care Compare)

720 Osterman Ave
Suite 103
Deerfield, IL 60015-4339
Phone (847) 945-3030

Hospital & facility affiliations

  • Admire Home Healthcare Agency, Inc Home health agency, Skokie, IL, CCN 147818
  • Guardian Home Health Care, LLC Home health agency, Northfield, IL, CCN 147785
  • Residential Home Health Home health agency, Northbrook, IL, CCN 147001
  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130

Merit-based Incentive Payment System (MIPS)

Final score
92.73 of 100Reported as individual
Quality
85.47
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36098718ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deerfield Medical Associates,S.C. Internal Medicine CurrentSince Aug 1, 1999 Accepting new patients

Locations

720 Osterman Ave
Ste 103
Deerfield, IL 60015
Phone (847) 374-1300

Interoperability endpoints

  • Direct secure messaging: deerfieldmedicalassociates.johnjstavrakos@133396.advancedmd-direct.com

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1215966684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 OSTERMAN AVE",
            "address_2": "STE 103",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154339",
            "telephone_number": "847-945-3335",
            "fax_number": "847-945-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 OSTERMAN AVE",
            "address_2": "SUITE 103",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154471",
            "telephone_number": "847-945-3030",
            "fax_number": "847-945-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAVRAKOS",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "36098718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield, IL

Sources for this page

Verify at the official NPI Registry.