Individual provider Active NPI

Nicole Fanya Siparsky, M.D., F.A.C.S.

  • Surgical Critical Care Physician
  • Chicago, IL
National Provider Identifier
1265639652
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
036-135778 Issued in IL
Practice address
1653 W Congress Pkwy # 785
Chicago, IL 60612-3833
Phone
(312) 942-6379
NPI assigned
Jun 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036135778 IL
Trauma Surgery Physician 2086S0127X 036-135778 IL
Surgical Critical Care Physician 2086S0102X 036-135778 IL Primary

Addresses

Primary practice location

1653 W Congress Pkwy # 785
Chicago, IL 60612-3833

Mailing address

1653 W Congress Pkwy # 785
Chicago, IL 60612-3833
Phone (312) 942-6379

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
I20140822001542 IL Practitioner - General Surgery 5890851109 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Boston University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1620 W Harrison St
Chicago, IL 60612-3801

1625 N Harlem Ave
Chicago, IL 60707-4303

1653 W Congress Pkwy
Chicago, IL 60612-3833

1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 563-2875

1725 W Harrison St
Chicago, IL 60612-3863

1725 W Harrison St
Suite 450
Chicago, IL 60612-4828
Phone (312) 563-4238

1725 W Harrison St
Suite 818
Chicago, IL 60612-3895
Phone (312) 942-5500

520 S Maple Ave
Oak Park, IL 60304-1022
Phone (708) 660-2240

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue52
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036135778ILMDSurgery Physician
036-135778ILMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2014 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2014 Accepting new patients
Rush University Medical Center CurrentSince Oct 1, 2020 Accepting new patients
Rush University Medical Group Surgery CurrentSince Oct 1, 2020 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

1653 W Congress Pkwy
#785
Chicago, IL 60612
Phone (312) 942-6379

1725 W Harrison St
Ste 425
Chicago, IL 60612
Phone (312) 563-2558

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

675 N Saint Clair St
Chicago, IL 60611
Phone (312) 664-3278

516 S Loomis St
Chicago, IL 60607
Phone (717) 975-6402

1725 W Harrison St
Ste 970
Chicago, IL 60612
Phone (312) 563-3447

1725 W Harrison St
Ste 810
Chicago, IL 60612
Phone (312) 942-6500

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1625 N Harlem Ave
Chicago, IL 60707
Phone (312) 256-8583

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

520 S Maple Ave
Oak Park, IL 60304
Phone (708) 383-9300

Interoperability endpoints

  • Direct secure messaging: nsiparsky118806@direct.rush.rush-health.com

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 3

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": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1265639652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY # 785",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-6379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY # 785",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-6379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIPARSKY",
        "first_name": "NICOLE",
        "middle_name": "FANYA",
        "name_prefix": "Dr.",
        "credential": "M.D., F.A.C.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-28",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036135778",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "IL",
            "license": "036-135778",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "IL",
            "license": "036-135778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.