Individual provider Active NPI

Bradley Ryan Nesemeier, MD

  • Otolaryngology Physician
  • Chicago, IL
National Provider Identifier
1669899803
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
036173628 Issued in IL
Practice address
1611 W Harrison St Ste 550
Chicago, IL 60612-4861
Phone
(312) 942-6100
Fax
(312) 942-6225
NPI assigned
Mar 26, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 036173628 IL Primary

Addresses

Primary practice location

1611 W Harrison St Ste 550
Chicago, IL 60612-4861

Mailing address

1611 W Harrison St Ste 550
Chicago, IL 60612-4861
Phone (312) 942-6100

Other practice location 1

915 Olentangy River Rd Fl 4
Columbus, OH 43212-3153
Phone (614) 366-3687

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
I20250327001892 IL Practitioner - Otolaryngology 3971811662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Louisville School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1611 W Harrison St
Suite 550
Chicago, IL 60612-4861
Phone (312) 942-6100

Hospital & facility affiliations

  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Center Otolaryngology CurrentSince Mar 21, 2025 Accepting new patients
Rush University Medical Group Otolaryngology CurrentSince Mar 21, 2025 Accepting new patients
Major Hospital Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1611 W Harrison St
Ste 550
Chicago, IL 60612
Phone (312) 563-4431

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1411 S Michigan Ave
Chicago, IL 60605
Phone (312) 454-2700

1725 W Harrison St
Ste 425
Chicago, IL 60612
Phone (312) 563-2558

1725 W Harrison St
Ste 758
Chicago, IL 60612
Phone (312) 942-3640

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.

Hospital & facility affiliations 2

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": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1669899803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST STE 550",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "312-942-6100",
            "fax_number": "312-942-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST STE 550",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "312-942-6100",
            "fax_number": "312-942-6225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 Olentangy River Rd Fl 4",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432123153",
            "country_code": "US",
            "telephone_number": "614-366-3687",
            "fax_number": "614-293-6176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NESEMEIER",
        "first_name": "BRADLEY",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-26",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036173628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.