Active NPI
Augustine Manadan, M.D.
- Rheumatology Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 036-100913
- Practice address
- 1725 W Harrison St
Suite 1017
Chicago, IL 60612-3841 - Phone
- (312) 942-6641
- NPI assigned
- Jul 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036-100913 | IL | |
| Rheumatology Physician | 207RR0500X | 036-100913 | IL | Primary |
Addresses
Primary practice location
1725 W Harrison St
Suite 1017
Chicago, IL 60612-3841
Mailing address
1611W Harrison St 510
Chicago, IL 60612-4861
Phone (312) 563-2800
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | amanadan@direct.ccprovider.org | Direct | Cook County |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Rheumatology
- Education
- Ohio State University College of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 633-7292
500 E 51St St
Chicago, IL 60615-2494
Phone (312) 572-2000
Hospital & facility affiliations
- John H Stroger Jr Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-100913 | IL | MD | Rheumatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rush University Medical Group | Internal Medicine | Current | Accepting new patients |
| Cook County | Current | Accepting new patients | |
| Cook County | Internal Medicine | Current | Accepting new patients |
| Rush University Medical Center | Internal Medicine | Current | Accepting new patients |
| Cook County | Current | Accepting new patients |
Locations
500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000
1611 W Harrison St
#510
Chicago, IL 60612
1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875
1611 W Harrison St
Ste 510
Chicago, IL 60612
Phone (312) 563-2800
1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600
1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100
1725 W Harrison St
Ste 1017
Chicago, IL 60612
Phone (312) 563-2800
75 Remittance Dr
Dept 1611
Chicago, IL 60675
Interoperability endpoints
- amanadan@direct.ccprovider.org
- amanadan3803@direct.rush.rush-health.com
Organizations & group practices 5
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.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1588612832
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1093819542
-
- Multi-Specialty Clinic/Center
- Chicago, IL
- NPI 1831219450
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1689165540
Hospital & facility affiliations 27
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": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619481600000",
"number": "1508881871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1611W HARRISON ST 510",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124861",
"telephone_number": "312-563-2800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1725 W HARRISON ST",
"address_2": "SUITE 1017",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123841",
"telephone_number": "312-942-6641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANADAN",
"first_name": "AUGUSTINE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-13",
"last_updated": "2021-04-27",
"certification_date": "2021-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036-100913",
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "IL",
"license": "036-100913",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "amanadan@direct.ccprovider.org",
"affiliation": "Y",
"affiliationName": "Cook County",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1969 W. Ogden Ave.",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606123723",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.