Individual provider Active NPI

Brian Griffin, PHD

  • Psychologist
  • Chicago, IL
National Provider Identifier
1265596845
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
441 E Erie St Apt 2511
Chicago, IL 60611-4426
Phone
(312) 475-1576
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X IL Primary

Addresses

Primary practice location

441 E Erie St Apt 2511
Chicago, IL 60611-4426

Mailing address

441 E Erie St Apt 2511
Chicago, IL 60611-4426
Phone (312) 475-1576

Other identifiers 1

IdentifierTypeStateIssuer
01673210OtherILBLUE CROSS

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040630000376 IL Practitioner - Clinical Psychologist 8921085713 Reassigns benefits to 1 organization
Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Northwestern University Feinberg Medical School, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

446 E Ontario St
100 Dept of Psychiatry
Chicago, IL 60611-4418
Phone (312) 695-5060

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
071-003464ILMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Aug 27, 2017 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 27, 2017 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

446 E Ontario St
Ste 7100
Chicago, IL 60611
Phone (312) 926-8058

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265596845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 E ERIE ST APT 2511",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114426",
            "telephone_number": "312-475-1576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 E ERIE ST APT 2511",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114426",
            "telephone_number": "312-475-1576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "BRIAN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "01673210",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.