Individual provider Active NPI

Sidney P. Regalado, M.D.

  • Diagnostic Radiology Physician
  • Evanston, IL
National Provider Identifier
1407841414
Registry record updated Dec 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036-108195 Issued in IL
Practice address
2650 Ridge Ave.
Department of Radiology
Evanston, IL 60201-1718
Phone
(847) 570-2160
Fax
(847) 570-2942
NPI assigned
Sep 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036-108195 IL Primary

Addresses

Primary practice location

2650 Ridge Ave.
Department of Radiology
Evanston, IL 60201-1718

Mailing address

2650 Ridge Ave.
Department of Radiology
Evanston, IL 60201-1718
Phone (847) 570-2160

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050721000520 IL Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 2668446550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1000 E Rollins Rd
Round Lake Beach, IL 60073-2228
Phone (224) 364-2273

1300 Oak Ave
Evanston, IL 60201-4205
Phone (847) 869-1300

2100 Pfingsten Rd
Glenview, IL 60026-1301

2650 Ridge Ave
Evanston, IL 60201-1700

2739 W Foster Ave
Chicago, IL 60625-3661
Phone (773) 878-8200

5145 N California
Hosps Suite 331
Chicago, IL 60625-3661
Phone (847) 570-2280

5145 N California Ave
Chicago, IL 60625-3661
Phone (773) 878-8200

524 Main St
Evanston, IL 60202-1815
Phone (224) 364-2273

6450 W Touhy Ave
Niles, IL 60714-4512

777 Park Ave W
Highland Park, IL 60035-2433

7900 Rollins Rd
Gurnee, IL 60031-1512

920 Milwaukee Ave
Lincolnshire, IL 60069-3839
Phone (847) 866-7846

9600 Gross Point Rd
Skokie, IL 60076-1214

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-108195ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Dec 15, 2009 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 15, 2009 Accepting new patients
Munster Radiology Group PC Diagnostic Radiology Past Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575

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

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

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

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 4

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": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544745600000",
    "number": "1407841414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-2160",
            "fax_number": "847-570-2942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-2160",
            "fax_number": "847-570-2942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGALADO",
        "first_name": "SIDNEY",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2018-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036-108195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.