Individual provider Active NPI

Brandy Burgos, MD

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1306472246
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036164196 Issued in IL
Practice address
3059 W 26TH St
Chicago, IL 60623-4131
Phone
(773) 584-6200
NPI assigned
Mar 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036164196 IL Primary

Addresses

Primary practice location

3059 W 26TH St
Chicago, IL 60623-4131

Mailing address

3059 W 26TH St
Chicago, IL 60623-4131

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
I20230703002324 IL Practitioner - Pediatric Medicine 8729447149 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036164196ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Esperanza Health Centers CurrentSince Jul 31, 2023 Accepting new patients
Esperanza Health Centers CurrentSince Jul 31, 2023 Accepting new patients

Locations

3059 W 26th St
Chicago, IL 60623
Phone (312) 243-3769

2001 S California Ave
Chicago, IL 60608
Phone (773) 484-1201

2001 S California Ave
Ste 100
Chicago, IL 60608
Phone (773) 640-5785

4700 S California Ave
Chicago, IL 60632
Phone (708) 713-0078

Interoperability endpoints

  • Direct secure messaging: brandy.burgos.1@11903.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/11903/brand/1/csg/1/fhir/r4

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": "1584835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1306472246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3059 W 26TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606234131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3059 W 26TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606234131",
            "telephone_number": "773-584-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOS",
        "first_name": "BRANDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-22",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036164196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.