Individual provider Active NPI

Miranda Anne Hart, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1437413432
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036137706 Issued in IL
Practice address
5215 N California Ave FL 7
Chicago, IL 60625-7014
Phone
(312) 666-3494
Fax
(773) 293-7220
NPI assigned
Jun 25, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125061026 IL
Internal Medicine Physician 207R00000X 036137706 IL Primary

Addresses

Primary practice location

5215 N California Ave FL 7
Chicago, IL 60625-7014

Mailing address

5215 N California Ave FL 7
Chicago, IL 60625-7014
Phone (312) 666-3494

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
I20150602002475 IL Practitioner - Internal Medicine 3274854260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Northwestern University Feinberg Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erie Family Health Center, IncGroup PAC ID 9537050422, 141 clinicians

Practice addresses (Care Compare)

5215 N California Ave
Suite F700
Chicago, IL 60625-8562
Phone (312) 666-3494

Hospital & facility affiliations

  • Swedish Hospital Hospital, Chicago, IL, CCN 140114

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125061026ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Erie Family Health Center Inc CurrentSince Jan 13, 2020 Accepting new patients

Locations

1701 W Superior St
Chicago, IL 60622
Phone (312) 432-7392

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381

5215 N California Ave
Ste F700
Chicago, IL 60625

Interoperability endpoints

  • Direct secure messaging: mhart368536@direct.ochin.org

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.

Hospital & facility affiliations 1

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": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1437413432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 N CALIFORNIA AVE FL 7",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606257014",
            "telephone_number": "312-666-3494",
            "fax_number": "773-293-7220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 N CALIFORNIA AVE FL 7",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606257014",
            "telephone_number": "312-666-3494",
            "fax_number": "773-293-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "MIRANDA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-25",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125061026",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036137706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.