Individual provider Active NPI

Nitet Charo, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Chicago Heights, IL
National Provider Identifier
1245429802
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016004955 Issued in IL
Practice address
30 E 15TH St
#206
Chicago Heights, IL 60411-3459
Phone
(708) 755-7871
Fax
(708) 756-3263
NPI assigned
Oct 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 016004955 IL Primary

Addresses

Primary practice location

30 E 15TH St
#206
Chicago Heights, IL 60411-3459

Mailing address

30 E 15TH St
#206
Chicago Heights, IL 60411-3459
Phone (708) 755-7871

Other identifiers 3

IdentifierTypeStateIssuer
016004955MedicaidIL
01625973OtherILBLUE CROSS BLUE SHIELD OF ILLINOIS
480030086OtherILRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016004955ILMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nitet Charo, DPM Foot & Ankle Surgery PastSince Jan 1, 1990 Accepting new patients
Keystone Orthopedic Specialists S C PastSince Feb 1, 2008 Accepting new patients

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": "1192752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1245429802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E 15TH ST",
            "address_2": "#206",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604113459",
            "telephone_number": "708-755-7871",
            "fax_number": "708-756-3263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E 15TH ST",
            "address_2": "#206",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604113459",
            "telephone_number": "708-755-7871",
            "fax_number": "708-756-3263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARO",
        "first_name": "NITET",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-19",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016004955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004955",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ILLINOIS",
            "identifier": "01625973",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480030086",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.