NPIMap

Individual provider Active NPI

Michael Magnetta, M.D.

  • Diagnostic Radiology Physician
  • Evanston, IL
National Provider Identifier
1508108226
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036.148026 Issued in IL
Practice address
2650 Ridge Ave.
Dept. of Radiology
Evanston, IL 60201
Phone
(847) 570-2475
Fax
(847) 570-2942
NPI assigned
Mar 20, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036.148026 IL Primary

Addresses

Primary practice location

2650 Ridge Ave.
Dept. of Radiology
Evanston, IL 60201

Mailing address

2650 Ridge Ave.
Dept. of Radiology
Evanston, IL 60201
Phone (847) 570-2475

Other practice location 1

251 E Huron St
Chicago, IL 60611-3055
Phone (312) 926-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, IL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20180801000031 PA Practitioner - Diagnostic Radiology 6507114071 Reassigns benefits to 1 organization
I20190725002501 IL Practitioner - Diagnostic Radiology 6507114071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Suite 2218a
Evanston, IL 60201-1700
Phone (847) 503-4222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.148026ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Nov 1, 2022 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
University of Pittsburgh Physicians Diagnostic Radiology CurrentSince Jul 1, 2018 Accepting new patients
Endeavor Health Medical Group CurrentSince Nov 1, 2022 Accepting new patients

Locations

251 E Huron St
Chicago, IL 60611

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553

Organizations & group practices 4

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 7

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": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1508108226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "DEPT. OF RADIOLOGY",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60201",
            "telephone_number": "847-570-2475",
            "fax_number": "847-570-2942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "DEPT. OF RADIOLOGY",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60201",
            "telephone_number": "847-570-2475",
            "fax_number": "847-570-2942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "251 E Huron St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606113055",
            "country_code": "US",
            "telephone_number": "312-926-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAGNETTA",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-20",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036.148026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.