Individual provider Active NPI

Cesar E Menendez, MD

  • Pediatrics Physician
  • La Grange Park, IL
National Provider Identifier
1699752485
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036064511 Issued in IL
Practice address
1137 Ostrander Ave
La Grange Park, IL 60526-1349
Phone
(773) 972-8925
NPI assigned
Dec 22, 2005
Last updated
Oct 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036064511 IL Primary

Addresses

Primary practice location

1137 Ostrander Ave
La Grange Park, IL 60526-1349

Mailing address

1137 Ostrander Ave
La Grange Park, IL 60526-1349
Phone (773) 972-8925

Other identifiers 2

IdentifierTypeStateIssuer
01621679OtherILBCBS OF IL
036064511MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036064511ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MP Pediatrics Pediatrics CurrentSince Mar 8, 2010 Accepting new patients
Advocate North Side Health Network Past Accepting new patients

Locations

5525 S Pulaski Rd
Ste 2-400
Chicago, IL 60629
Phone (773) 284-6270

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1699752485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 OSTRANDER AVE",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605261349",
            "telephone_number": "773-972-8925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 OSTRANDER AVE",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605261349",
            "telephone_number": "773-972-8925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENENDEZ",
        "first_name": "CESAR",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036064511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "01621679",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036064511",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange Park, IL

Sources for this page

Verify at the official NPI Registry.