NPIMap

Individual provider Active NPI

Agata Bednarz, M.D.

  • Gastroenterology Physician
  • Maywood, IL
National Provider Identifier
1477671527
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036168895 Issued in IL
Practice address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone
(708) 216-9000
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X CDR.0002211 CO
Gastroenterology Physician 207RG0100X 9654370-1205 UT
Gastroenterology Physician 207RG0100X 036168895 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153-3328

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

1010 Three Springs Blvd Ste 270
Durango, CO 81301-8296
Phone (970) 764-3800

Other names 1

  • Agata Bednarz-Volk Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address agata.bednarz@direct.imail.org
Direct Messaging Address abednarz244383@direct.luhs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO, SD, IL, ID5 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20200213000342 TX Practitioner - GastroenterologyPractitioner - Internal Medicine 6305750142 Reassigns benefits to 1 organization
I20230224002634 CO Practitioner - Gastroenterology 6305750142
I20230725002166 SD Practitioner - Gastroenterology 6305750142 Reassigns benefits to 1 organization
I20240405003110 IL Practitioner - Gastroenterology 6305750142
I20260324000754 ID Practitioner - Gastroenterology 6305750142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Rochester School of Medicine and Dentistry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pocatello Health Services LLCGroup PAC ID 6608927637, 171 clinicians

Practice addresses (Care Compare)

777 Hospital Way
Pocatello, ID 83201-5175
Phone (208) 239-1720

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux21

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Family of Doctors CurrentSince Dec 1, 2019 Accepting new patients
Avera McKennan Gastroenterology CurrentSince Jun 26, 2023 Accepting new patients
Seton Family of Doctors Current Accepting new patients
Loyola University Medical Center CurrentSince Feb 25, 2024 Accepting new patients
Avera McKennan Current Accepting new patients
Loyola University Medical Center CurrentSince Feb 25, 2024 Accepting new patients
Avera McKennan CurrentSince Jun 26, 2023 Accepting new patients
Seton Family of Doctors CurrentSince Dec 1, 2019 Accepting new patients

Locations

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

1000 E 23rd St
Ste 100
Sioux Falls, SD 57105
Phone (605) 322-1625

1400 N Interstate 35
Ste 300
Austin, TX 78701
Phone (512) 324-8300

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

Interoperability endpoints

  • Direct secure messaging: abednarz346667@ahs.direct-ci.com
  • Direct secure messaging: agata.bednarz.1@4690.direct.athenahealth.com

Organizations & group practices 9

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 8

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1477671527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Three Springs Blvd Ste 270",
            "address_purpose": "LOCATION",
            "city": "Durango",
            "state": "CO",
            "postal_code": "813018296",
            "country_code": "US",
            "telephone_number": "970-764-3800",
            "fax_number": "970-764-3840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEDNARZ",
        "first_name": "AGATA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CO",
            "license": "CDR.0002211",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "UT",
            "license": "9654370-1205",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036168895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agata.bednarz@direct.imail.org",
            "affiliation": "N",
            "address_1": "900 Round Valley Dr Ste 200",
            "city": "Park City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840607552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abednarz244383@direct.luhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AGATA",
            "last_name": "BEDNARZ-VOLK",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.