Joseph M Civantos, MD

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

036086038 Issued in IL

Practice address

71 W 156TH St
Suite 400
Harvey, IL 60426-4265

Phone

(708) 596-8710

Fax

(708) 596-9820

NPI assigned

Jul 22, 2005

Last updated

Feb 4, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, IN2 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

Specialty

Ophthalmology

Education

Columbia University College of Physicians and Surgeons, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Illinois Retina Associates, PLLCGroup PAC ID 6709799810, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ingalls Memorial Hospital Hospital, Harvey, IL, CCN 140191

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jcivantos@illret.intellechartdirect.net
• Direct secure messaging: jcivantos1240308@adventhealth.direct-ci.com
• Direct secure messaging: jcivantos4059@direct.rush.rush-health.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Illinois Retina Associates PLLC

  dba The Retina Center

  • Retina Specialist (Ophthalmology) Physician
  • Orland Park, IL
  • NPI 1225038870

  IN

  Medicare reassignment Care Compare group NPD
• Adventist Health Partners, Inc

  dba Glenoaks Anesthesia

  • Anesthesiology Physician
  • Glendale Heights, IL
  • NPI 1912942012
  NPD (past)
• Adventist Health Partners, Inc

  dba Hinsdale Primary Care

  • Family Medicine Physician
  • Hinsdale, IL
  • NPI 1952339939
  NPD (past)
• Adventist Health Partners,Inc

  dba Glendale Family Practice

  • Family Medicine Physician
  • Bloomingdale, IL
  • NPI 1043255888
  NPD (past)
• Eye Center Physicians, LTD.

  • Ophthalmology Physician
  • Chicago, IL
  • NPI 1992715650
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ingalls Memorial Hospital

  • General Acute Care Hospital
  • Harvey, IL
  • NPI 1598756686
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1336149053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11516 183RD PL STE SW",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604679471",
            "telephone_number": "708-877-1300",
            "fax_number": "708-596-8719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 W 156TH ST",
            "address_2": "SUITE 400",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604264265",
            "telephone_number": "708-596-8710",
            "fax_number": "708-596-9820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIVANTOS",
        "first_name": "JOSEPH",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036086038",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "IL",
            "license": "036086038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "180015438",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086038",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "180030696",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcivantos@illret.intellechartdirect.net",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "address_1": "71 W 156th St",
            "address_2": "Suite 400",
            "city": "Harvey",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604264265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Children and Parents Excelling
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• Children's Habilitation Center
• Raj Chinnappan
• David R Chow, MD
• Clarence Johnson Transportation Inc
• Ralph Clark
• Jack A Cohen, MD
• Tonya Echols Cole, M.D.
• Betty Coleman-Bradley

• Retina Specialist (Ophthalmology) Physician in Harvey, IL
• Providers in Harvey, IL by specialty
• Retina Specialist (Ophthalmology) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.