NPIMap

Individual provider Active NPI

Wilberto Nieves Neira, MD

  • Gynecologic Oncology Physician
  • Chicago, IL
National Provider Identifier
1235214982
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
036139777 Issued in IL
Practice address
250 E Superior St
Suite 05-2168 Gynecologic Oncology
Chicago, IL 60611-2914
Phone
(312) 695-0990
Fax
(312) 472-4706
NPI assigned
Oct 25, 2006
Last updated
Apr 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036-139777 IL
Gynecologic Oncology Physician 207VX0201X 25MA07442500 NJ
Gynecologic Oncology Physician 207VX0201X 036139777 IL Primary

Addresses

Primary practice location

250 E Superior St
Suite 05-2168 Gynecologic Oncology
Chicago, IL 60611-2914

Mailing address

680 N Lake Shore Dr
Suite #1000
Chicago, IL 60611-4546
Phone (312) 695-0665

Other identifiers 2

IdentifierTypeStateIssuer
8990905MedicaidIL
8990905MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wilberto.nieves@direct.ccprovider.org Direct Cook County

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160224002984 IL Practitioner - Obstetrics/GynecologyPractitioner - Gynecological Oncology 7719922814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Gynecological Oncology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook CountyGroup PAC ID 2860398088, 770 clinicians

Practice addresses (Care Compare)

1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 633-7292

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
74.7
Promoting interoperability
100
Improvement activities
40
Cost
85.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-139777ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County Current Accepting new patients
Cook County Obstetrics & Gynecology CurrentSince Jun 29, 2019 Accepting new patients
Cook County CurrentSince Jun 29, 2019 Accepting new patients
John H Stroger Jr Hospital Cook County Past Accepting new patients

Locations

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

Interoperability endpoints

  • Direct secure messaging: wilberto.nieves@direct.ccprovider.org

Organizations & group practices 4

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.

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1235214982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "SUITE #1000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-695-0665",
            "fax_number": "312-695-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E SUPERIOR ST",
            "address_2": "SUITE 05-2168 GYNECOLOGIC ONCOLOGY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112914",
            "telephone_number": "312-695-0990",
            "fax_number": "312-472-4706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEVES NEIRA",
        "first_name": "WILBERTO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-139777",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "NJ",
            "license": "25MA07442500",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "IL",
            "license": "036139777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8990905",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8990905",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wilberto.nieves@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.