Ken Gabriel Doverte, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

209018290 Issued in IL

Practice address

1420 Renaissance Dr Ste 207
Park Ridge, IL 60068-1342

Phone

(847) 296-6161

Fax

(847) 574-7444

NPI assigned

Nov 7, 2018

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Rehabilitation Care, LLCGroup PAC ID 8628253259, 21 clinicians

Nova Medico SCGroup PAC ID 9133219827, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202

Merit-based Incentive Payment System (MIPS)

Final score

97.89 of 100Reported as group

Quality

100

Improvement activities

40

Cost

59.63

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Advanced Rehabilitation Care, LLC

  • Physical Medicine & Rehabilitation Physician
  • Chicago, IL
  • NPI 1285942722
  Medicare reassignment Care Compare group NPD
• Nova Medico S.C.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Park Ridge, IL
  • NPI 1871689208
  Medicare reassignment Care Compare group NPD
• Senf NP Family Medicine PLLC

  • Surgery Physician
  • Schaumburg, IL
  • NPI 1821702432
  Medicare reassignment NPD
• United Wound Care Institute-Illinois

  • Internal Medicine Physician
  • Naperville, IL
  • NPI 1669257440
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  IL

  Medicare reassignment NPD
• Trio Health Medical Il NP Partners PLLC

  • Nurse Practitioner
  • Evanston, IL
  • NPI 1497637011
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate Condell Medical Center

  • Mobile Mammography Clinic/Center
  • Gurnee, IL
  • NPI 1023262441

  Hospital

  Care Compare affiliation
• Advocate Condell Medical Center

  • General Acute Care Hospital
  • Libertyville, IL
  • NPI 1124272547
  Care Compare affiliation
• Advocate Condell Medical Center

  • Mobile Mammography Clinic/Center
  • Grayslake, IL
  • NPI 1770737199

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1417425547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 RENAISSANCE DR STE 207",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681342",
            "telephone_number": "847-296-6161",
            "fax_number": "847-574-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 RENAISSANCE DR STE 207",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681342",
            "telephone_number": "847-296-6161",
            "fax_number": "847-574-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVERTE",
        "first_name": "KEN GABRIEL",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-07",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209018290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Kristin Doran, MD
• Jeslyn Dorband
• Taylor Patrice Dorlack, PHD, BCBA, NCSP
• Delaney Dossey, LPC
• Michael Dougherty, MD
• Dr. Kevin R. Orloski LTD
• Dr. Maria Faklaris, P.C.
• Dr. Michael J. Palliser, DPM,PC
• Dr. Richard Aronoff, LTD
• Dr. Speron Plastic Surgery, S.C.

• Adult Health Nurse Practitioner in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Adult Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.

Verify at the official NPI Registry.