Individual provider Active NPI

Robert Medairos

  • Student in an Organized Health Care Education/Training Program
  • Chicago, IL
National Provider Identifier
1639601644
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1013 S Laflin St
Apartment 2
Chicago, IL 60607-4619
Phone
(414) 805-0788
NPI assigned
Mar 29, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1013 S Laflin St
Apartment 2
Chicago, IL 60607-4619

Mailing address

1013 S Laflin St
Apartment 2
Chicago, IL 60607-4619
Phone (414) 805-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20220927000971 NC Practitioner - Urology 3678801107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Rush Medical College of Rush University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

2301 Erwin Rd
Durham, NC 27705-4699
Phone (919) 684-8111

2351 Erwin Rd
Durham, NC 27705-4699
Phone (919) 684-8111

40 Duke Medicine Cir
Durham, NC 27710-4000
Phone (919) 684-8111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients

Locations

2100 Erwin Rd
Durham, NC 27705
Phone (919) 648-8111

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

Interoperability endpoints

  • Direct secure messaging: rmedairos527462@direct.medicine.duke.edu

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.

Hospital & facility affiliations 8

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": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1639601644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 S LAFLIN ST",
            "address_2": "APARTMENT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074619",
            "telephone_number": "414-805-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 S LAFLIN ST",
            "address_2": "APARTMENT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074619",
            "telephone_number": "414-805-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDAIROS",
        "first_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-29",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.