Marisa A Carter, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036.162765 Issued in IL

Practice address

1127 N Oakley Blvd FL 2
Chicago, IL 60622-3507

Phone

(312) 770-2040

NPI assigned

May 29, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Family Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primecare Community Health, Inc.Group PAC ID 6204722077, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Presence Saints Mary and Elizabeth Medical Center Hospital, Chicago, IL, CCN 140180
• Saint Francis Hospital-Evanston Hospital, Evanston, IL, CCN 140080
• Presence Saint Joseph Hospital - Chicago Hospital, Chicago, IL, CCN 140224

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.

• Primecare Community Health, Inc.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1558532739
  Medicare reassignment Care Compare group NPD
• Primecare Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1891541215
  NPD
• Primecare Community Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1225010911

  Family Medicine

  NPD
• Primecare Community Health Inc

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1700230398
  NPD (past)
• Primecare Community Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1336692359
  NPD (past)

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

• Presence Chicago Hospitals Network

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1679659585
  Care Compare affiliation
• Saint Francis Hospital - Evanston LLC

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1982442398
  Care Compare affiliation
• Saint Mary of Nazareth Hospital - Chicago LLC

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1265270607
  Care Compare affiliation

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1649838384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 N OAKLEY BLVD FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223507",
            "telephone_number": "312-770-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 N OAKLEY BLVD FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223507",
            "telephone_number": "312-770-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "MARISA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125.074315",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.162765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keme Heaven Carter, M.D.
• Kenika Lionta Carter
• Laura C Carter
• Lisa Marie Carter, PHYSICAL THERAPIST
• Mackensey Carter, LCSW
• Megan Laura Carter, M.S., CCC-SLP
• Miakarla Carter
• Michael F. Carter, M.D.
• Michel Antonia Carter
• Molly Carter, LCPC

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.