Active NPI
Francisco J Miyares, M.D.
- Internal Medicine Physician
- Rockford, IL
National Provider Identifier
1225088693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 39514
- Practice address
- 301 E. State St.
Rockford, IL 61104 - Phone
- (815) 668-7810
- Fax
- (815) 714-6219
- NPI assigned
- May 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036085264 | IL | |
| Internal Medicine Physician | 207R00000X | 39514 | WI | Primary |
Addresses
Primary practice location
301 E. State St.
Rockford, IL 61104
Mailing address
213 N Racine Ave
Ste 100
Chicago, IL 60607-1644
Phone (312) 733-9730
Other practice location 1
205 Parker St
Boscobel, WI 53805-1642
Phone (608) 375-4112
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F400218933 | Other | IL | MEDICARE PTAN |
| 036085264 | Medicaid | IL | |
| P00196872 | Other | IL | RR METRAHEALTH SOUTH IL |
| P00242646 | Other | IL | METRAHEALTH RR NORTH IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036085264 | IL | MD | Internal Medicine Physician |
| 39514 | WI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital of Boscobel | Current | Accepting new patients | |
| Memorial Hospital of Boscobel | Current | Accepting new patients |
Locations
711 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-1302
205 Parker St
Boscobel, WI 53805
Phone (608) 375-4112
507 S Main St
Viroqua, WI 54665
Phone (608) 637-2101
Interoperability endpoints
- fmiyares3813@direct.emplifyhealth.org
Organizations & group practices 2
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.
-
- Critical Access Hospital
- Boscobel, WI
- NPI 1760459846
-
- Medicare Defined Swing Bed Hospital Unit
- Boscobel, WI
- NPI 1497712624
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550534400000",
"number": "1225088693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 N RACINE AVE",
"address_2": "STE 100",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606071644",
"telephone_number": "312-733-9730",
"fax_number": "773-866-8014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 E. STATE ST.",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "61104",
"telephone_number": "815-668-7810",
"fax_number": "815-714-6219"
}
],
"practiceLocations": [
{
"address_1": "205 Parker St",
"address_purpose": "LOCATION",
"city": "Boscobel",
"state": "WI",
"postal_code": "538051642",
"country_code": "US",
"telephone_number": "608-375-4112",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIYARES",
"first_name": "FRANCISCO",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2019-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036085264",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "39514",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "F400218933",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036085264",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR METRAHEALTH SOUTH IL",
"identifier": "P00196872",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "METRAHEALTH RR NORTH IL",
"identifier": "P00242646",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.