Individual provider Active NPI

Elias Murciano, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1568445112
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036107113 Issued in IL
Practice address
3924 W Fullerton Ave
Chicago, IL 60647-2228
Phone
(773) 276-2229
Fax
(773) 276-2190
NPI assigned
Nov 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036107113 IL Primary

Addresses

Primary practice location

3924 W Fullerton Ave
Chicago, IL 60647-2228

Mailing address

1431 N Western Ave
Suite #406
Chicago, IL 60622-1797
Phone (312) 633-5841

Other identifiers 1

IdentifierTypeStateIssuer
036107113MedicaidIL

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
I20100728000566 IL Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 5395878334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primecare Community Health, Inc.Group PAC ID 6204722077, 41 clinicians

Practice addresses (Care Compare)

1127 N Oakley Blvd
FL 2
Chicago, IL 60622-3507
Phone (312) 491-5495

1431 N Western Ave
Suite 401
Chicago, IL 60622-1797
Phone (312) 491-5495

1431 N Western Ave
Suite 406
Chicago, IL 60622-1774
Phone (312) 491-5495

3924 W Fullerton Ave
Chicago, IL 60647-2228
Phone (312) 491-5495

5635 W Belmont Ave
Chicago, IL 60634-4384
Phone (773) 736-1830

Hospital & facility affiliations

  • Presence Saints Mary and Elizabeth Medical Center Hospital, Chicago, IL, CCN 140180

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036107113ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primecare Community Health Inc CurrentSince Jan 27, 2006 Accepting new patients
Primecare Community Health, Inc. Family Medicine Current Accepting new patients
Primecare Community Health, Inc. Family Medicine CurrentSince Jan 27, 2006 Accepting new patients
Primecare Community Health, Inc. Family Medicine Current Accepting new patients
Primecare Community Health, Inc. Family Medicine Past Accepting new patients
Primecare Community Health Inc. Past Accepting new patients
Primecare Community Health Inc Past Accepting new patients

Locations

1431 N Western Ave
Ste 406
Chicago, IL 60622
Phone (312) 491-5495

3924 W Fullerton Ave
Chicago, IL 60647
Phone (773) 276-2229

1431 N Western Ave
Ste 209
Chicago, IL 60622
Phone (312) 491-5435

1431 N Western Ave
Ste 202
Chicago, IL 60622
Phone (773) 276-2272

1431 N Western Ave
Ste 401
Chicago, IL 60622
Phone (312) 633-5841

5635 W Belmont Ave
Chicago, IL 60634
Phone (773) 736-1830

1127 N Oakley Blvd
Fl 2
Chicago, IL 60622
Phone (312) 633-5841

Interoperability endpoints

  • Direct secure messaging: elias.murciano.1@16494.direct.athenahealth.com

Organizations & group practices 7

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 1

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326067200000",
    "number": "1568445112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 N WESTERN AVE",
            "address_2": "SUITE #406",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221797",
            "telephone_number": "312-633-5841",
            "fax_number": "312-491-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3924 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472228",
            "telephone_number": "773-276-2229",
            "fax_number": "773-276-2190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURCIANO",
        "first_name": "ELIAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2012-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036107113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036107113",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.