Individual provider Active NPI

Dennys Omar Vera Daner, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1508108531
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036138145 Issued in IL
Practice address
1501 S California Ave
Family Medicine Department
Chicago, IL 60608-1732
Phone
(773) 257-6097
NPI assigned
Mar 16, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125062327 IL
Family Medicine Physician 207Q00000X 036138145 IL Primary

Addresses

Primary practice location

1501 S California Ave
Family Medicine Department
Chicago, IL 60608-1732

Mailing address

1501 S California Ave
Family Medicine Department
Chicago, IL 60608-1732
Phone (773) 257-6097

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
I20160406000973 IL Practitioner - Family Practice 7214235365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
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)

3109 W Armitage Ave
Chicago, IL 60647-3818
Phone (773) 384-4933

Hospital & facility affiliations

  • Holy Cross Hospital Hospital, Chicago, IL, CCN 140133
  • Mt Sinai Hospital Medical Center Hospital, Chicago, IL, CCN 140018

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036138145ILMDFamily Medicine Physician
125062327ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai Community Foundation CurrentSince Jun 1, 2016 Accepting new patients
Mount Sinai Community Foundation Current Accepting new patients
Sinai Community Foundation CurrentSince Jun 1, 2016 Accepting new patients

Locations

3109 W Armitage Ave
Chicago, IL 60647
Phone (773) 292-5555

2701 W 68th St
Chicago, IL 60629
Phone (773) 471-8000

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

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

1501 S California Ave
Chicago, IL 60608
Phone (773) 257-6770

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 5

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": "1363392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1508108531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S CALIFORNIA AVE",
            "address_2": "FAMILY MEDICINE DEPARTMENT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081732",
            "telephone_number": "773-257-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S CALIFORNIA AVE",
            "address_2": "FAMILY MEDICINE DEPARTMENT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081732",
            "telephone_number": "773-257-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERA DANER",
        "first_name": "DENNYS",
        "middle_name": "OMAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-16",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125062327",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036138145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.