Individual provider Active NPI

Jose Rivera Guerrero, M.D.

  • Internal Medicine Physician
  • Crest Hill, IL
National Provider Identifier
1316190028
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01078841A Issued in IN
Practice address
16003 Executive Dr
Crest Hill, IL 60403-0500
Phone
(815) 280-5796
NPI assigned
Oct 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.142242 IL
Hospitalist Physician 208M00000X 036.142242 IL
Internal Medicine Physician 207R00000X 01078841A IN Primary

Addresses

Primary practice location

16003 Executive Dr
Crest Hill, IL 60403-0500

Mailing address

16003 Executive Dr
Crest Hill, IL 60403-0500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160419001638 TX Practitioner - Internal Medicine 5597935874 Reassigns benefits to 1 organization
I20170426001894 IL Practitioner - Internal MedicinePractitioner - Hospitalist 5597935874 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harold Jaimes, M.D. P.CGroup PAC ID 3274595426, 2 clinicians
Premiumhealthcare PCGroup PAC ID 8224315239, 2 clinicians

Practice addresses (Care Compare)

3153 W Fullerton Ave
Chicago, IL 60647-2809
Phone 7733954600100

3800 Highland Ave
Suite 111
Downers Grove, IL 60515-1558
Phone (630) 434-0020

Hospital & facility affiliations

  • Advocate Good Samaritan Hospital Hospital, Downers Grove, IL, CCN 140288
  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.142242ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premiumhealthcare PC Internal Medicine CurrentSince Mar 18, 2017 Accepting new patients
Ipc Healthcare Services of Texas, PLLC Internal Medicine CurrentSince Sep 12, 2019 Accepting new patients
Harold Jaimes, M.D. P.C Internal Medicine CurrentSince Mar 5, 2020 Accepting new patients
Harold Jaimes, M.D., S.C. Internal Medicine CurrentSince Mar 5, 2020 Accepting new patients
Associated Cardiology Consultants of New Mexico Past Accepting new patients

Locations

6342 S Pulaski Rd
Chicago, IL 60629
Phone (773) 284-8601

3153 W Fullerton Ave
Chicago, IL 60647
Phone (773) 278-6604

16003 Executive Dr
Crest Hill, IL 60403
Phone (815) 744-2344

3800 Highland Ave
Ste 111
Downers Grove, IL 60515
Phone (630) 241-3779

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BJGFBA/Endpoint/BJGFBA
  • Direct secure messaging: jriveraguerrero251866@direct.myadvocateaurora.org

Organizations & group practices 5

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": "1224892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1316190028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16003 EXECUTIVE DR",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604030500",
            "fax_number": "708-923-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16003 EXECUTIVE DR",
            "city": "CREST HILL",
            "state": "IL",
            "postal_code": "604030500",
            "telephone_number": "815-280-5796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA GUERRERO",
        "first_name": "JOSE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-25",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.142242",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036.142242",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01078841A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crest Hill, IL

Sources for this page

Verify at the official NPI Registry.