Matthew Robert Andersen, M.D.
Individual provider Active NPI Nephrology Physician · Berwyn, IL
NPI 1265637623 · NPPES record last updated Jan 24, 2023
Key facts
- NPI
- 1265637623
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- 036114336 (IL)
- Practice address
- 6948 W Windsor Ave
Berwyn, IL 60402-3335 - Phone
- (708) 749-4617
- Fax
- (708) 749-0094
- NPI assigned
- Jun 18, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Nephrology
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Nephrology Associates of Northern Illinois LTD
Practice addresses (Care Compare)
6948 W Windsor Ave
Berwyn, IL 60402-3335
Phone (708) 749-4617
800 Biesterfield Rd
Elk Grove Village, IL 60007-3372
Phone (847) 981-3680
Hospital & facility affiliations
- FKC - Berwyn
- FMC - Cicero
- Macneal Hospital
- Loyola University Medical Center
- Macneal Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081015000041 | IL | Practitioner - Nephrology |
6103984406 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036114336 | IL | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nephrology Associates of Northern Illinois, LTD. | Nephrology | Current |
Accepting new patients |
| Nephrology Associates of Northern Illinois, LTD. | Nephrology | Current |
Accepting new patients |
| Linda Roberts & Associates Inc | Past | Accepting new patients |
Locations
6827 Stanley Ave
Berwyn, IL 60402
Phone (708) 749-4617
6948 W Windsor Ave
Berwyn, IL 60402
Phone (708) 393-7533
3825 Highland Ave
Ste 4C
Downers Grove, IL 60515
Phone (630) 968-1595
800 Biesterfield Rd
Ste 104
Elk Grove Village, IL 60007
Phone (847) 593-9182
120 Spalding Dr
Ste 410
Naperville, IL 60540
Phone (630) 369-0780
120 W 22nd St
Oak Brook, IL 60523
120 W 22nd St
Ste 200
Oak Brook, IL 60523
Phone (630) 575-5000
855 Madison St
Oak Park, IL 60302
Phone (708) 386-1000
Interoperability endpoints
- mandersen49709@direct.acumenmd.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 036114336 | IL | Yes |
Addresses
Primary practice location
6948 W Windsor Ave
Berwyn, IL 60402-3335
Mailing address
120 W 22ND St Ste 200
Oak Brook, IL 60523-1563
Phone (630) 573-5000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036 114336 | Medicaid | IL |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | credentialing@nephdocs.com | Direct |
Other providers in Berwyn, IL
- Amanda Arevalo, P.C.
- Kyle T Amber
- Mark Amdur
- American Home Medical Supply LLC
- Jennifer Thai Andersen
- Lisa K Anderson-Shaw
- Anastasiya Andreeva
- Bose Andrews
- Catherine Anichini
- Jonathan Aniciete
All providers in Berwyn, IL · Nephrology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.