Individual provider Active NPI

David J Flores, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1407849078
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036113814 Issued in IL
Practice address
3348 W 87TH St
Chicago, IL 60652-3767
Phone
(773) 776-4471
Fax
(773) 564-3510
NPI assigned
Aug 29, 2005
Last updated
Dec 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01060028A IN
Family Medicine Physician 207Q00000X 036113814 IL Primary

Addresses

Primary practice location

3348 W 87TH St
Chicago, IL 60652-3767

Mailing address

213 N Racine Ave
Ste 100
Chicago, IL 60607-1644
Phone (312) 733-9730

Other identifiers 2

IdentifierTypeStateIssuer
200522980MedicaidIN
0090000854OtherILBCBS GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20200727000234 TN Practitioner - Family Practice 0143256560 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DX Mso, PLLC CurrentSince Jun 9, 2020 Accepting new patients
Landmark Medical of Tennessee PC CurrentSince Mar 27, 2023 Accepting new patients
Landmark Medical of Tennessee PC CurrentSince Mar 27, 2023 Accepting new patients
St Margaret Mercy Healthcare Centers Family Medicine Past Accepting new patients
Dwic of Tampa Bay, Inc Past Accepting new patients
St Margaret Mercy Healthcare Centers Family Medicine Past Accepting new patients
St Margaret Mercy Healthcare Centers, Inc. Past Accepting new patients

Locations

7755 Center Ave
Ste 630
Huntington Beach, CA 92647
Phone (877) 240-3112

700 E 54th St N
Sioux Falls, SD 57104
Phone (423) 458-1426

210 Westwood Pl
Ste 110
Brentwood, TN 37027
Phone (615) 206-2462

1025 Peerless Xing NW
Cleveland, TN 37312
Phone 4234765990 ext. 104

Interoperability endpoints

  • Direct secure messaging: dflores@landmarkhealth-direct.org
  • Direct secure messaging: ms_dflore91@landmarkhealth-direct.org

Organizations & group practices 7

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": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1407849078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 N RACINE AVE",
            "address_2": "STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071644",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3348 W 87TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606523767",
            "telephone_number": "773-776-4471",
            "fax_number": "773-564-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-29",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01060028A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036113814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200522980",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "0090000854",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.