Pablo E Chagoya, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036112461 Issued in IL

Practice address

6545 Cermak Rd
Berwyn, IL 60402-2313

Phone

(708) 788-0077

NPI assigned

Oct 14, 2005

Last updated

Sep 22, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pablo.chagoya.1@16862.direct.athenahealth.com
• Direct secure messaging: pablo.chagoya.p1@direct.northshorehealth.nextgenshare.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.

• Northshore Health Centers Inc

  dba NorthShore Regional Health Centers

  • Federally Qualified Health Center (FQHC)
  • Merrillville, IN
  • NPI 1114257300
  Medicare reassignment NPD
• Dr Chagoya Pediatrics LTD

  • Pediatrics Physician
  • Berwyn, IL
  • NPI 1720313240
  Authorized official Same address or phone
• Northshore Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Chicago, IN
  • NPI 1336992999
  NPD
• Northshore Health Centers, Inc.

  dba NorthShore Chesterton Health Center

  • Federally Qualified Health Center (FQHC)
  • Chesterton, IN
  • NPI 1568856045

  Pediatrics

  NPD

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1235128075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022313",
            "telephone_number": "708-788-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022313",
            "telephone_number": "708-788-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAGOYA",
        "first_name": "PABLO",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "IL",
            "license": "036112461",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036112461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-112461-1",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cermak Children's Clinic, S.C.
• Cermak Optical, Inc
• Bianca Cervantes, LCPC
• Hilda Cervantes
• Ron J Chacko, MD
• Bobby Chan, M.D.
• Margaret Chao, PA
• Robert Frank Charbonneau, D.D.S.
• Scott Chavin
• Brigette Chelchowski, PA-C

• Pediatrics Physician in Berwyn, IL
• Providers in Berwyn, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.

Verify at the official NPI Registry.