Individual provider Active NPI

Erica Hirsh

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1235495904
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036.138913 Issued in IL
Practice address
9119 S Exchange Ave
Chicago, IL 60617-4225
Phone
(773) 768-5000
NPI assigned
Apr 7, 2012
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036.138913 IL Primary

Addresses

Primary practice location

9119 S Exchange Ave
Chicago, IL 60617-4225

Mailing address

9119 S Exchange Ave
Chicago, IL 60617-4225
Phone (773) 768-5000

Other practice location 1

2500 Metrohealth Dr
Cleveland, OH 44109-1900
Phone (216) 778-4486

Other identifiers 1

IdentifierTypeStateIssuer
036138913MedicaidIL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160128002470 IL Practitioner - Pediatric Medicine 6901048487 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.138913ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Family Health Center, Inc. CurrentSince Jan 25, 2016 Accepting new patients
Chicago Family Health Center Inc CurrentSince Jan 25, 2016 Accepting new patients
Carl B Toren MD Past Accepting new patients

Locations

9119 S Exchange Ave
Chicago, IL 60617

Interoperability endpoints

  • Direct secure messaging: erica.hirsh.1@18277.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1333756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1235495904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9119 S EXCHANGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174225",
            "telephone_number": "773-768-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9119 S EXCHANGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174225",
            "telephone_number": "773-768-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Metrohealth Dr",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441091900",
            "country_code": "US",
            "telephone_number": "216-778-4486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIRSH",
        "first_name": "ERICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.138913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036138913",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.