Individual provider Active NPI

Guido Alarcon Mantilla, MD

  • Pediatric Endocrinology Physician
  • Miami, FL
National Provider Identifier
1588158562
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
036169965 Issued in IL
Practice address
3100 SW 62ND Ave
Miami, FL 33155-3009
Phone
(305) 669-5873
NPI assigned
Jun 21, 2018
Last updated
May 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Endocrinology Physician 2080P0205X 036169965 IL Primary

Addresses

Primary practice location

3100 SW 62ND Ave
Miami, FL 33155-3009

Mailing address

1801 W Taylor St
Chicago, IL 60612-4795

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
I20240725003811 IL Practitioner - Pediatric MedicinePractitioner - Endocrinology 2466998422 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Endocrinology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5525 S Pulaski Rd
Chicago, IL 60629-4400
Phone (312) 413-3000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036169965ILMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Aug 6, 2024 Accepting new patients
The Board of Trustees of the University of Illinois Pediatric Endocrinology CurrentSince Aug 6, 2024 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Cook County Current Accepting new patients
Cook County CurrentSince Aug 15, 2024 Accepting new patients
Cook County CurrentSince Aug 15, 2024 Accepting new patients

Locations

1801 W Taylor St
Chicago, IL 60612
Phone (312) 355-1700

1900 W Polk St
Ste 220C
Chicago, IL 60612

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

5525 S Pulaski Rd
Chicago, IL 60629
Phone (773) 432-0100

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

840 S Wood St
#856
Chicago, IL 60612
Phone (312) 413-1429

845 W Wilson Ave
Chicago, IL 60640
Phone (312) 744-1295

Interoperability endpoints

  • Direct secure messaging: galarconmantilla169270@uihealth.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1588158562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SW 62ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331553009",
            "telephone_number": "305-669-5873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALARCON MANTILLA",
        "first_name": "GUIDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-21",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "IL",
            "license": "036169965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.