Individual provider Active NPI

Larissa Verda, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1457599862
Registry record updated Oct 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036122921 Issued in IL
Practice address
1900 W Polk St
15 Floor - Dept of Int Med
Chicago, IL 60612-3723
Phone
(312) 864-7229
NPI assigned
Jan 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 125052153 IL
Internal Medicine Physician 207R00000X 036122921 IL Primary

Addresses

Primary practice location

1900 W Polk St
15 Floor - Dept of Int Med
Chicago, IL 60612-3723

Mailing address

8200 Lincoln Ave
Unit 413
Skokie, IL 60077-2423
Phone (773) 983-6484

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
I20110223001062 IL Practitioner - Internal Medicine 4587845557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Sinai Community FoundationGroup PAC ID 5991600405, 247 clinicians

Practice addresses (Care Compare)

1401 S California Ave
Chicago, IL 60608-1858
Phone (773) 522-6656

California Ave at 15TH St
Chicago, IL 60608-1858
Phone (773) 542-2000

Hospital & facility affiliations

  • Icare Home Health Home health agency, Chicago, IL, CCN 148039
  • Mt Sinai Hospital Medical Center Hospital, Chicago, IL, CCN 140018
  • Schwab Rehabilitation Hospital Inpatient rehabilitation facility, Chicago, IL, CCN 143025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036122921ILMDInternal Medicine Physician
125052153ILMDGeneral Acute Care Hospital

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai Community Foundation Internal Medicine CurrentSince May 14, 2017 Accepting new patients
Mount Sinai Community Foundation Current Accepting new patients
Mount Sinai Community Foundation Internal Medicine CurrentSince May 14, 2017 Accepting new patients

Locations

1501 S California Ave
#7131
Chicago, IL 60608

4646 N Marine Dr
Fl 6
Chicago, IL 60640
Phone (773) 564-6150

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

1501 S California Ave
#7140
Chicago, IL 60608
Phone (773) 257-4758

4646 N Marine Dr
Chicago, IL 60640
Phone (773) 564-5102

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1232668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540944000000",
    "number": "1457599862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 LINCOLN AVE",
            "address_2": "UNIT 413",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772423",
            "telephone_number": "773-983-6484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W POLK ST",
            "address_2": "15 FLOOR - DEPT OF INT MED",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123723",
            "telephone_number": "312-864-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDA",
        "first_name": "LARISSA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-23",
        "last_updated": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "125052153",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036122921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.