Johana B Gimenezrodriguez, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036.152253 Issued in IL

Practice address

1276 N Clybourn Ave
Chicago, IL 60610-2003

Phone

(312) 337-1073

Fax

(312) 337-7616

NPI assigned

Jun 28, 2017

Last updated

May 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Johana B Gimenez Other name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: johana.gimenez-rodriguez.1@31131.direct.athenahealth.com

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.

• Near North Health Service Corporation

  dba Winfield Moody Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1821079088
  Medicare reassignment NPD
• Near North Health Service Corporation

  dba Near North Health Family Health Center at Oakwood Shores

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1740166255
  NPD
• Nava Segall MD SC

  • Pediatric Adolescent Medicine Physician
  • Chicago, IL
  • NPI 1528233087
  NPD (past)

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1417478629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 N CLYBOURN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102003",
            "telephone_number": "312-337-1073",
            "fax_number": "312-337-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 N CLYBOURN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102003",
            "telephone_number": "312-337-1073",
            "fax_number": "312-337-7616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4116 N Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606183028",
            "country_code": "US",
            "telephone_number": "773-883-2350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 Founders Ln Ste 100",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "IL",
            "postal_code": "626503924",
            "country_code": "US",
            "telephone_number": "217-243-0300",
            "fax_number": "217-245-6775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4500 Parsons Blvd",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113552205",
            "country_code": "US",
            "telephone_number": "718-670-5535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIMENEZRODRIGUEZ",
        "first_name": "JOHANA",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.152253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "036.152253",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHANA",
            "last_name": "GIMENEZ",
            "middle_name": "B",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Marcia Gilson, OTR/L
• Robin Gilson, PSYD
• Sarah Feenstra Gilson, MD
• Renee Petzel Gimbar, PHARM.D
• Sabrina Gimenez
• Hillary Gimpel Wolff, MSW, LCSW
• Grace Everett Gimpel
• Brian Christopher Gin, M.D., PH.D.
• Phuc Nhoc Gin, PA-C
• Gina E Sims DPM PC

• Pediatrics Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.