Individual provider Active NPI

David De Ramos, DO

  • Family Medicine Physician
  • Bloomingdale, IL
National Provider Identifier
1639120785
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36081151 Issued in IL
Practice address
303 E Army Trail Rd
Suite 300
Bloomingdale, IL 60108-2169
Phone
(630) 545-8300
Fax
(630) 980-9736
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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 36081151 IL Primary

Addresses

Primary practice location

303 E Army Trail Rd
Suite 300
Bloomingdale, IL 60108-2169

Mailing address

303 E Army Trail Rd
Ste 300
Bloomingdale, IL 60108-2169
Phone (630) 545-8300

Other identifiers 1

IdentifierTypeStateIssuer
036081151MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address david.deramos.1@380.direct.athenahealth.com

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
I20050907001044 IL Practitioner - Family Practice 3375575657 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36081151ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Partners,Inc Family Medicine CurrentSince Jan 1, 1998 Accepting new patients
Adventist Health Partners, Inc. Current Accepting new patients
Adventist Health Partners, Inc. CurrentSince Jan 1, 1998 Accepting new patients
Adventist Midwest Health Past Accepting new patients

Locations

303 E Army Trail Rd
Ste 300
Bloomingdale, IL 60108
Phone (630) 530-4449

396 Remington Blvd
Ste 231
Bolingbrook, IL 60440
Phone (630) 312-4301

550 E Boughton Rd
Bolingbrook, IL 60440
Phone (630) 739-2878

Interoperability endpoints

  • Direct secure messaging: david.deramos.1@380.direct.athenahealth.com
  • Direct secure messaging: dderamos1239519@adventhealth.direct-ci.com

Organizations & group practices 4

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": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1639120785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E ARMY TRAIL RD",
            "address_2": "STE 300",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082169",
            "telephone_number": "630-545-8300",
            "fax_number": "630-980-9736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E ARMY TRAIL RD",
            "address_2": "SUITE 300",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082169",
            "telephone_number": "630-545-8300",
            "fax_number": "630-980-9736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE RAMOS",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "36081151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036081151",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "david.deramos.1@380.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "303 E Army Trail Rd",
            "address_2": "SUITE 300",
            "city": "Bloomingdale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601082169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

Verify at the official NPI Registry.