Augusto Miravalle, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

036118267 Issued in IL

Practice address

1725 W Harrison St Ste 309
Chicago, IL 60612-3844

Phone

(312) 942-8011

Fax

(970) 226-6707

NPI assigned

Jan 29, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO, IL2 enrollments

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 2

Specialty

Neurology

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rush University Medical Center Hospital, Chicago, IL, CCN 140119
• Rush Oak Park Hospital Hospital, Oak Park, IL, CCN 140063

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Rush University Medical Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542

  Neurology

  Medicare reassignment Care Compare group NPD
• Advanced Neurology of Colorado, LLC

  • Specialist
  • Fort Collins, CO
  • NPI 1972556991
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Rush Oak Park Hospital Inc

  • General Acute Care Hospital
  • Oak Park, IL
  • NPI 1558391706
  Care Compare affiliation
• Rush University Medical Center

  • Children's Hospital
  • Chicago, IL
  • NPI 1801908728
  Care Compare affiliation
• Rush University Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1932213600
  Care Compare affiliation

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1629216627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 309",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123844",
            "telephone_number": "312-942-8011",
            "fax_number": "970-226-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 309",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123844",
            "telephone_number": "312-942-8011",
            "fax_number": "970-226-6707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2121 E. Harmony Road",
            "address_2": "Suite 180",
            "address_purpose": "LOCATION",
            "city": "Ft Collins",
            "state": "CO",
            "postal_code": "80528",
            "country_code": "US",
            "telephone_number": "970-226-6111",
            "fax_number": "970-226-6707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRAVALLE",
        "first_name": "AUGUSTO",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-29",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036118267",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "0047246",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020217800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susanna Miranda, DNP, APRN, AGNP-C
• Tymeka Artheia Miranda, DEVELOPMENTAL THERAP
• Amber Mirando, MD, MPH
• Santi V Miranti, PHD
• B Florian Miranzadeh, DO
• Mahsa Mirazimy, PSY.D.
• Muhammad Mire
• Naheed Mirebrahimi
• Edmund Vincent Mirecki, RPH
• Raquel Renee Mireles, RD, LDN

• Neurology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Neurology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; 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.

Verify at the official NPI Registry.