Individual provider Active NPI

Gina C Marafino, M.D.

  • Dermatology Physician
  • Northbrook, IL
National Provider Identifier
1679682959
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Practice address
400 Skokie Blvd
Suite 475
Northbrook, IL 60062-7930
Phone
(847) 272-4433
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

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
Dermatology Physician 207N00000X IL Primary

Addresses

Primary practice location

400 Skokie Blvd
Suite 475
Northbrook, IL 60062-7930

Mailing address

400 Skokie Blvd
Suite 475
Northbrook, IL 60062-7930
Phone (847) 272-4433

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
I20040419000854 IL Practitioner - Dermatology 3779578752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036105374ILMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Partners of the North Shore LLC Dermatology CurrentSince Sep 30, 2008 Accepting new patients

Locations

400 Skokie Blvd
Ste 475
Northbrook, IL 60062
Phone (847) 272-4433

4711 Golf Rd
Ste 910
Skokie, IL 60076
Phone (847) 673-6505

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679682959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SKOKIE BLVD",
            "address_2": "SUITE 475",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600627930",
            "telephone_number": "847-272-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SKOKIE BLVD",
            "address_2": "SUITE 475",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600627930",
            "telephone_number": "847-272-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARAFINO",
        "first_name": "GINA",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.