Individual provider Active NPI

Robert K Brogadir, D.P.M.

  • Podiatrist
  • Buffalo Grove, IL
National Provider Identifier
1417970724
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Practice address
1306 Madison Dr
Buffalo Grove, IL 60089-6826
Phone
(847) 634-3348
Fax
(847) 634-6882
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X IL Primary

Addresses

Primary practice location

1306 Madison Dr
Buffalo Grove, IL 60089-6826

Mailing address

1306 Madison Dr
Buffalo Grove, IL 60089-6826
Phone (847) 634-3348

Other identifiers 1

IdentifierTypeStateIssuer
60001331OtherILBLUE CROSS- BLUE SHIELD

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061030000063 IL Practitioner - Podiatry 7618974973 Practice locations: Libertyville, IL; Long Grove, IL; Niles, IL; Orland Park, IL; Oswego, IL; South Barrington, IL; St Charles, IL; Vernon Hills, IL…

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Buffalo Grove, IL 60089
Phone (847) 634-3348

12450 Regency Pkwy
Huntley, IL 60142-5800
Phone (847) 961-7490

156 W Dundee
Wheeling, IL 60090-4801
Phone (847) 865-8100

505 N Hunt Club Rd
Gurnee, IL 60031-2430
Phone (847) 855-1380

5656 N Newcastle Ave
The Danish Home of Chicago
Chicago, IL 60631-3108
Phone (773) 775-7383

6840 W Touhy Ave
Niles, IL 60714-4520
Phone (847) 647-8994

777 Church St
Lake Zurich, IL 60047-1404
Phone (847) 550-0555

8021 W 151St St
Orland Park, IL 60462-2963
Phone (708) 403-2732

901 Florsheim Dr
Libertyville, IL 60048-5200
Phone (847) 816-6644

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue248
Removal or shaving of skin growth200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen Rivera LTD Past Accepting new patients
Senior Healthcare Solutions Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417970724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 MADISON DR",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600896826",
            "telephone_number": "847-634-3348",
            "fax_number": "847-634-6882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 MADISON DR",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600896826",
            "telephone_number": "847-634-3348",
            "fax_number": "847-634-6882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGADIR",
        "first_name": "ROBERT",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS- BLUE SHIELD",
            "identifier": "60001331",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo Grove, IL

Sources for this page

Verify at the official NPI Registry.