Individual provider Active NPI

Bruno Vincent Decaria, M.D.

  • Anesthesiology Physician
  • Chicago, IL
National Provider Identifier
1609009208
Registry record updated Aug 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
125056820 Issued in IL
Practice address
251 E Huron St
Chicago, IL 60611-2908
Phone
(312) 926-2000
NPI assigned
Aug 29, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 125056820 IL Primary

Addresses

Primary practice location

251 E Huron St
Chicago, IL 60611-2908

Mailing address

1934 N Leavitt St
Apartment #2
Chicago, IL 60647-4456
Phone (304) 723-8457

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
I20130802000442 IL Practitioner - Anesthesiology 6709027758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
West Virginia University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

251 E Huron
Chicago, IL 60611-2908

251 E Huron St
Chicago, IL 60611-2908

259 E Erie St
Chicago, IL 60611-2930
Phone (312) 503-1944

4445 W Irving Park Rd
Chicago, IL 60641-2808

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125056820ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2013 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2013 Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

251 E Huron St
Chicago, IL 60611

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

Organizations & group practices 2

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": "1251504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251504000000",
    "number": "1609009208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1934 N LEAVITT ST",
            "address_2": "APARTMENT #2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474456",
            "telephone_number": "304-723-8457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E HURON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112908",
            "telephone_number": "312-926-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECARIA",
        "first_name": "BRUNO",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-29",
        "last_updated": "2009-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "125056820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.