Individual provider Active NPI

Biaisha Yutrina Washington, APN/FNP

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1437687464
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209015904 Issued in IL
Practice address
6307 S Stewart Ave
Chicago, IL 60621-3116
Phone
(773) 962-3939
NPI assigned
Jun 4, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209015904 IL Primary

Addresses

Primary practice location

6307 S Stewart Ave
Chicago, IL 60621-3116

Mailing address

6307 S Stewart Ave
Chicago, IL 60621-3116
Phone (773) 962-3939

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191213000505 IL Practitioner - Nurse Practitioner 3476986985 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foundation for Outreach ServicesGroup PAC ID 3375507163, 36 clinicians
Rajiv Kandala M D S CGroup PAC ID 0345130977, 10 clinicians

Practice addresses (Care Compare)

326 W 64TH St
Chicago, IL 60621-3114
Phone (773) 962-3900

7531 S Stony Island Ave
Suite 164
Chicago, IL 60649-3954
Phone (773) 947-2831

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rajiv Kandala M D S C CurrentSince Oct 1, 2024 Accepting new patients
Foundation for Outreach Services CurrentSince Dec 1, 2019 Accepting new patients
Southside Primary Care Group SC CurrentSince Oct 1, 2024 Accepting new patients

Locations

326 W 64th St
Chicago, IL 60621
Phone (773) 962-3900

6307 S Stewart Ave
Chicago, IL 60621
Phone (773) 776-8800

7531 S Stony Island Ave
Chicago, IL 60649
Phone (773) 947-7310

7531 S Stony Island Ave
#164
Chicago, IL 60649
Phone (773) 947-2831

7531 S Stony Island Ave
Ste 164
Chicago, IL 60649
Phone (773) 947-2831

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1496534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1437687464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6307 S STEWART AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606213116",
            "telephone_number": "773-962-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6307 S STEWART AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606213116",
            "telephone_number": "773-962-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "BIAISHA",
        "middle_name": "YUTRINA",
        "name_prefix": "Miss",
        "credential": "APN/FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.