Individual provider Active NPI

Bhrandon Harris, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1306189790
Registry record updated Sep 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036140660 Issued in IL
Practice address
1919 W Taylor St
Suite 153
Chicago, IL 60612-7246
Phone
(312) 413-9118
NPI assigned
Apr 3, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X IL
Family Medicine Physician 207Q00000X 036140660 IL Primary

Addresses

Primary practice location

1919 W Taylor St
Suite 153
Chicago, IL 60612-7246

Mailing address

1919 W Taylor St
Suite 153
Chicago, IL 60612-7246

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
I20160818000992 IL Practitioner - Family Practice 4587966940 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, 1,134 clinicians

Practice addresses (Care Compare)

1919 W Taylor St
Mc663
Chicago, IL 60612-7246
Phone (312) 996-0750

Hospital & facility affiliations

  • University of Illinois Hospital and Clinics Hospital, Chicago, IL, CCN 140150

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036140660ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Family Medicine CurrentSince Sep 21, 2016 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Endeavor Health Medical Group CurrentSince Sep 21, 2016 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Jul 13, 2016 Accepting new patients
The Board of Trustees of the University of Illinois Family Medicine CurrentSince Jul 13, 2016 Accepting new patients
Board of Trustees of the University of Illinois Past Accepting new patients

Locations

1919 W Taylor St
#663
Chicago, IL 60612
Phone (312) 996-0750

9532 Eagle Way
Chicago, IL 60678

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

1919 W Taylor St
Ste 153
Chicago, IL 60612
Phone (312) 413-9118

722 W Maxwell St
Chicago, IL 60607
Phone (312) 996-2901

722 W Maxwell St
#235
Chicago, IL 60607
Phone (312) 433-4114

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

Interoperability endpoints

  • Direct secure messaging: bharris11574@uihealth.direct-ci.com

Organizations & group practices 6

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 1

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": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1306189790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 W TAYLOR ST",
            "address_2": "SUITE 153",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 W TAYLOR ST",
            "address_2": "SUITE 153",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127246",
            "telephone_number": "312-413-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "BHRANDON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-03",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036140660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.