Fred Peter Biasiello III, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019027965 Issued in IL

Practice address

5445 Grand Ave
Ste 202
Gurnee, IL 60031-1725

Phone

(847) 244-2775

Fax

(847) 244-2777

NPI assigned

Jun 29, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Procare Dental Group, P.C.

  • Dentist
  • Gurnee, IL
  • NPI 1124185467
  NPD (past)

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246233600000",
    "number": "1376771345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 E ALGONQUIN RD",
            "address_2": "STE 300",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600054373",
            "telephone_number": "847-640-1112",
            "fax_number": "847-510-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 GRAND AVE",
            "address_2": "STE 202",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600311725",
            "telephone_number": "847-244-2775",
            "fax_number": "847-244-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIASIELLO",
        "first_name": "FRED",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-29",
        "last_updated": "2009-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019027965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eugene Berkovich, O.D.
• Best Vital RX Inc
• Beyond Rehab LLC
• Thomas Bezouska, DDS
• Kopal Bhatti, LPC
• Michael Del Castillo Bibay, PT
• Albino Tirao Bismonte, MD
• Blain and Associates, PC
• Daun Denise Blain
• Jerry A. Blecha, MS, LCPC, CADC

• General Practice Dentistry in Gurnee, IL
• Providers in Gurnee, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.