Roy C Bliley, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

036068954 Issued in IL

Practice address

13011 S 104TH Ave Ste 100
Palos Park, IL 60464-1508

Phone

(708) 274-3278

Fax

(708) 274-3299

NPI assigned

Apr 12, 2006

Last updated

Sep 11, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 9

Electronic endpoints 1

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

Specialty

Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)

Education

University of Kansas School of Med (KC/Wich/Sal), 1981

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rbliley-sm@heartcc.com

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.

• Heart Care Centers of Illinois, SC

  • Cardiovascular Disease Physician
  • Palos Park, IL
  • NPI 1508810086
  Medicare reassignment NPD
• Heart Care Centers of Illinois, SC

  • Physician Assistant
  • Palos Park, IL
  • NPI 1104238534

  Cardiovascular Disease

  NPD (past)
• Uropartners, LLC

  • Durable Medical Equipment & Medical Supplies
  • Geneva, IL
  • NPI 1659124683
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1225092992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13011 S 104TH AVE STE 100",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604641508",
            "telephone_number": "708-478-3600",
            "fax_number": "708-478-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13011 S 104TH AVE STE 100",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604641508",
            "telephone_number": "708-274-3278",
            "fax_number": "708-274-3299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19001 Old Lagrange Rd",
            "address_purpose": "LOCATION",
            "city": "Mokena",
            "state": "IL",
            "postal_code": "604488012",
            "country_code": "US",
            "telephone_number": "708-478-4224",
            "fax_number": "708-478-4033",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10260 191st St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Mokena",
            "state": "IL",
            "postal_code": "604488802",
            "country_code": "US",
            "telephone_number": "708-478-4224",
            "fax_number": "708-478-4033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLILEY",
        "first_name": "ROY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036068954",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036068954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP PTAN NUMBER",
            "identifier": "CN2703",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE COOK",
            "identifier": "060042338",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE WILL",
            "identifier": "060043541",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "236551",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD",
            "identifier": "01621208",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036068954",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "236550",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP PTAN NUMBER",
            "identifier": "CD8033",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1508810086",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rbliley-sm@heartcc.com",
            "affiliation": "N",
            "address_1": "13011 S 104th Ave Ste 100",
            "city": "Palos Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604641508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• B M Khan DO PC
• Linda G Baer, PSYD
• Brian Edwin Bailey, D.M.D.
• Jonathan L. Belgrad, M.D.
• Mallory Marie Berg, FNP-C
• Bridget Ann Boam
• Noor Bsul, PHARMD
• Emilee Anne Caldwell
• Bienvenido Camacho
• Noel Camba, M.D.

• Interventional Cardiology Physician in Palos Park, IL
• Providers in Palos Park, IL by specialty
• Interventional Cardiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; 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.
• 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.