Individual provider Active NPI

Kristopher Toribio

  • Certified Registered Nurse Anesthetist
  • Evanston, IL
National Provider Identifier
1386246213
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209022401 Issued in IL
Practice address
2650 Ridge Ave.
Dept. of Anesthosiology
Evanston, IL 60201-1777
Phone
(847) 570-2760
Fax
(847) 570-2921
NPI assigned
Nov 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041425604 IL
Certified Registered Nurse Anesthetist 367500000X 209022401 IL Primary

Addresses

Primary practice location

2650 Ridge Ave.
Dept. of Anesthosiology
Evanston, IL 60201-1777

Mailing address

2650 Ridge Ave.
Dept. of Anesthosiology
Evanston, IL 60201-1777
Phone (847) 570-2760

Other practice location 1

1000 Central St
Evanston, IL 60201-1777
Phone (847) 570-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201204000748 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305257833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Illinois, LLCGroup PAC ID 4688893878, 404 clinicians

Practice addresses (Care Compare)

1423 Chicago Rd
Chicago Heights, IL 60411-3400
Phone (708) 756-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
041425604ILMDRegistered Nurse
209022401ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Nov 19, 2020 Accepting new patients
Endeavor Health Medical Group CurrentSince Nov 19, 2020 Accepting new patients
Northstar Anesthesia of Illinois, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 20, 2022 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

1000 Central St
Evanston, IL 60201
Phone (847) 570-1000

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

Organizations & group practices 3

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 1

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": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1386246213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "DEPT. OF ANESTHOSIOLOGY",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011777",
            "telephone_number": "847-570-2760",
            "fax_number": "847-570-2921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "DEPT. OF ANESTHOSIOLOGY",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011777",
            "telephone_number": "847-570-2760",
            "fax_number": "847-570-2921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Central St",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602011777",
            "country_code": "US",
            "telephone_number": "847-570-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TORIBIO",
        "first_name": "KRISTOPHER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-16",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041425604",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209022401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.