Individual provider Active NPI

Francisco J Miyares, M.D.

  • Internal Medicine Physician
  • Rockford, IL
National Provider Identifier
1225088693
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
39514 Issued in WI
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

Updated by the provider on Feb 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
F400218933OtherILMEDICARE PTAN
036085264MedicaidIL
P00196872OtherILRR METRAHEALTH SOUTH IL
P00242646OtherILMETRAHEALTH 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040825001128 WI Practitioner - Internal MedicinePractitioner - Emergency Medicine 1658358387 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036085264ILMDInternal Medicine Physician
39514WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital of Boscobel CurrentSince Mar 6, 2019 Accepting new patients
Memorial Hospital of Boscobel CurrentSince Mar 6, 2019 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.