Active NPI
Alyssa Rae Cohen, M.D.
- Pediatrics Physician
- Chicago, IL
National Provider Identifier
1336500263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036.148492
- Practice address
- 225 E Chicago Ave
Chicago, IL 60611-2991 - Phone
- (312) 227-4000
- NPI assigned
- Mar 20, 2016
- Last updated
- Sep 30, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 125.068458 | IL | |
| Pediatrics Physician | 208000000X | 036.148492 | IL | Primary |
Addresses
Primary practice location
225 E Chicago Ave
Chicago, IL 60611-2991
Mailing address
714 W Buckingham PL Apt 2E
Chicago, IL 60657-6502
Phone (216) 346-9506
Other practice location 1
240 E Huron St
McGaw Pavilion Suite 1-200
Chicago, IL 60611-2909
Phone (312) 503-7975
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160712002380 | IL | Order and Referring Only - Pediatric Medicine | 1153613146 |
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- University of Rochester School of Medicine and Dentistry, 2016
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
225 E Chicago Ave
Chicago, IL 60611-2991
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.148492 | IL | MD | Pediatrics Physician |
| 125.068458 | IL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lurie Children's Medical Group, LLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569801600000",
"number": "1336500263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "714 W BUCKINGHAM PL APT 2E",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606576502",
"telephone_number": "216-346-9506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 E CHICAGO AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112991",
"telephone_number": "312-227-4000"
}
],
"practiceLocations": [
{
"address_1": "240 E Huron St",
"address_2": "McGaw Pavilion Suite 1-200",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606112909",
"country_code": "US",
"telephone_number": "312-503-7975",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COHEN",
"first_name": "ALYSSA",
"middle_name": "RAE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-20",
"last_updated": "2019-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "125.068458",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036.148492",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.