NPIMap

Individual provider Active NPI

Alfredo Jose Mena Lora, M.D.

  • Infectious Disease Physician
  • Chicago, IL
National Provider Identifier
1639307283
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
036129801 Issued in IL
Practice address
2875 W 19TH St
Chicago, IL 60623
Phone
(773) 484-1000
NPI assigned
Jun 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036129081 IL
Student in an Organized Health Care Education/Training Program 390200000X 125056547 IL
Infectious Disease Physician 207RI0200X 036129801 IL Primary

Addresses

Primary practice location

2875 W 19TH St
Chicago, IL 60623

Mailing address

2875 W 19TH St
Chicago, IL 60623-3501
Phone (773) 484-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150803000469 IL Practitioner - Infectious DiseasePractitioner - Internal Medicine 2163736208 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Anthony Health AffiliatesGroup PAC ID 1254321474, 95 clinicians
The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, 1,134 clinicians

Practice addresses (Care Compare)

2875 W 19TH St
Chicago, IL 60623-3501
Phone (773) 484-4425

840 S Wood St MC
787 Uic Medicine
Chicago, IL 60612-4325
Phone (312) 413-8687

Hospital & facility affiliations

  • University of Illinois Hospital and Clinics Hospital, Chicago, IL, CCN 140150
  • Saint Anthony Hospital Hospital, Chicago, IL, CCN 140095

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036129081ILMDSurgery Physician
125056547ILMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Jul 1, 2015 Accepting new patients
The Board of Trustees of the University of Illinois Infectious Disease CurrentSince Jul 1, 2015 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Pathology Services Illinois, LTD Current Accepting new patients
Saint Anthony Health Affiliates Past Accepting new patients

Locations

2875 W 19th St
Chicago, IL 60623
Phone (773) 484-4300

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

840 S Wood St
#787
Chicago, IL 60612
Phone (312) 413-8687

7732 Solutions Ctr
Chicago, IL 60677

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

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

Interoperability endpoints

  • Direct secure messaging: amenalora17291@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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1639307283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2875 W 19TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606233501",
            "telephone_number": "773-484-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 W 19TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60623",
            "telephone_number": "773-484-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENA LORA",
        "first_name": "ALFREDO",
        "middle_name": "JOSE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-22",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036129081",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125056547",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": "036129801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.