Individual provider Active NPI

Steven J Nicorata, D.D.S.

  • General Practice Dentistry
  • Palos Heights, IL
National Provider Identifier
1629147301
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
6741 W 127TH St
Palos Heights, IL 60463-2253
Phone
(708) 448-1125
Fax
(708) 448-1730
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X IL Primary

Addresses

Primary practice location

6741 W 127TH St
Palos Heights, IL 60463-2253

Mailing address

6741 W 127TH St
Palos Heights, IL 60463-2253
Phone (708) 448-1125

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160203002776 IL Order and Referring Only - DentistPractitioner - Dentist 7214231752

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.020095ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Steven J. Nicorata, D.D.S., P.C. General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629147301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6741 W 127TH ST",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604632253",
            "telephone_number": "708-448-1125",
            "fax_number": "708-448-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6741 W 127TH ST",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604632253",
            "telephone_number": "708-448-1125",
            "fax_number": "708-448-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICORATA",
        "first_name": "STEVEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.