Individual provider Active NPI

Ben Remor Escalante Inventor, CNP

  • Gerontology Nurse Practitioner
  • Berwyn, IL
National Provider Identifier
1659405215
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
Practice address
3303 Grove Ave
#312
Berwyn, IL 60402-3432
Phone
(708) 945-4990
NPI assigned
Mar 15, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X IL Primary

Addresses

Primary practice location

3303 Grove Ave
#312
Berwyn, IL 60402-3432

Mailing address

3303 Grove Ave
#312
Berwyn, IL 60402-3432
Phone (708) 945-4990

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040920001113 IL Practitioner - Nurse Practitioner 8820066657 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209005054ILMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Jan 2, 2024 Accepting new patients
Theodore Handrup MD LTD PastSince Jan 1, 1996 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7420

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659405215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 GROVE AVE",
            "address_2": "#312",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023432",
            "telephone_number": "708-945-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 GROVE AVE",
            "address_2": "#312",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023432",
            "telephone_number": "708-945-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INVENTOR",
        "first_name": "BEN REMOR",
        "middle_name": "ESCALANTE",
        "name_prefix": "Mr.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.