Individual provider Active NPI

Michael R Carr, M.D.

  • Pediatric Cardiology Physician
  • Chicago, IL
National Provider Identifier
1285770925
Registry record updated Jul 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
036130481 Issued in IL
Practice address
225 East Chicago Avenue
Box 21 Lurie Children'S Hospital,
Chicago, IL 60611
Phone
(312) 227-4100
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 0101102544 VA
Pediatric Cardiology Physician 2080P0202X 036130481 IL Primary

Addresses

Primary practice location

225 East Chicago Avenue
Box 21 Lurie Children'S Hospital,
Chicago, IL 60611

Mailing address

225 East Chicago Avenue
Box 21 Lurie Children'S Hospital,
Chicago, IL 60611
Phone (312) 227-4100

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
I20130227000568 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 6305091174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Loyola University of Chicago, Stritch School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lurie Children'S Medical Group Inc.Group PAC ID 4789597279, 142 clinicians

Practice addresses (Care Compare)

1131 Techny Rd
Northbrook, IL 60062-5503
Phone (800) 543-7362

1895 Arbor Glen Blvd
Schaumburg, IL 60195-3114
Phone (312) 227-8249

225 E Chicago Ave
Chicago, IL 60611-2991
Phone (312) 227-6415

3722 Touhy Ave
Skokie, IL 60076-3941
Phone (800) 543-7362

Hospital & facility affiliations

  • Ann & Robert H Lurie Childrens Hospital of Chicago Hospital, Chicago, IL, CCN 143300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036130481ILMDPediatric Cardiology Physician
0101102544VAMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lurie Children'S Medical Group Inc CurrentSince Oct 26, 2012 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Claims Remittance
Carol Stream, IL 60122

225 E Chicago Ave
#21
Chicago, IL 60611
Phone (312) 227-2200

225 E Chicago Ave
Chicago, IL 60611
Phone (312) 227-6415

225 E Chicago Ave
#118
Chicago, IL 60611

737 N Michigan Ave
Ste 2040
Chicago, IL 60611

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.

Hospital & facility affiliations 2

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1285770925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 EAST CHICAGO AVENUE",
            "address_2": "BOX 21 LURIE CHILDREN'S HOSPITAL,",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "312-227-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 EAST CHICAGO AVENUE",
            "address_2": "BOX 21 LURIE CHILDREN'S HOSPITAL,",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "312-227-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "VA",
            "license": "0101102544",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "IL",
            "license": "036130481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.