NPIMap

Individual provider Active NPI

Ricardo Manuel De Oliveira Soares, MD. FEBU

  • Urology Physician
  • Sycamore, IL
National Provider Identifier
1255853859
Registry record updated Aug 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
036150089 Issued in IL
Practice address
1850 Gateway Dr
Sycamore, IL 60178-3192
Phone
(815) 758-8671
NPI assigned
Jul 14, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 036150089 IL Primary

Addresses

Primary practice location

1850 Gateway Dr
Sycamore, IL 60178-3192

Mailing address

21 N Fremont St
Naperville, IL 60540

Other practice location 1

1 Kish Hospital Dr
Dekalb, IL 60115-9602
Phone (815) 756-1521

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
I20190826000782 IL Practitioner - Urology 1850664269 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1850 Gateway Dr
Sycamore, IL 60178-3192
Phone (630) 232-0280

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection37

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jun 14, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 14, 2023 Accepting new patients
Central Dupage Physician Group CurrentSince Jul 14, 2019 Accepting new patients
Central Dupage Physician Group CurrentSince Jul 14, 2019 Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

251 E Huron St
Chicago, IL 60611

1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

1850 Gateway Dr
Ste 203
Sycamore, IL 60178
Phone (815) 766-3942

1850 Gateway Dr
Ste 100
Sycamore, IL 60178
Phone (815) 217-3252

1850 Gateway Dr
Sycamore, IL 60178
Phone (815) 217-3252

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1255853859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 N FREMONT ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "60540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 GATEWAY DR",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783192",
            "telephone_number": "815-758-8671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Kish Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Dekalb",
            "state": "IL",
            "postal_code": "601159602",
            "country_code": "US",
            "telephone_number": "815-756-1521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE OLIVEIRA SOARES",
        "first_name": "RICARDO",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "MD. FEBU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-14",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036150089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sycamore, IL

Sources for this page

Verify at the official NPI Registry.