Andrea M. Bazan, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036-095548 Issued in IL

Practice address

1600 West Dempster Street
Suite #120
Park Ridge, IL 60068

Phone

(847) 299-7888

Fax

(847) 299-7844

NPI assigned

Sep 15, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 2

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

Internal Medicine

Education

Chicago College of Medicine and Surgery, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Geri Care LTDGroup PAC ID 5991794513, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Home Health Care Serv Home health agency, Oakbrook, IL, CCN 147150
• Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223
• Alden Estates of Evanston Nursing home, Evanston, IL, CCN 145907

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: abazan252317@direct.myadvocateaurora.org

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.

• Geri Care LTD

  • Family Medicine Physician
  • Park Ridge, IL
  • NPI 1629000732
  Medicare reassignment Care Compare group NPD

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

• Advocate Health and Hospitals Corporation

  dba Advocate Lutheran General Hospital

  • General Acute Care Hospital
  • Park Ridge, IL
  • NPI 1164539730
  Care Compare affiliation
• Alden Estates of Evanston, Inc.

  • Skilled Nursing Facility
  • Evanston, IL
  • NPI 1518953728

  Nursing home

  Care Compare affiliation
• Ehs Home Health Care Service Inc

  dba Advocate Home Health Services

  • Home Health Agency
  • Oak Brook, IL
  • NPI 1598732075
  Care Compare affiliation

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1699871293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 WEST 24TH PLACE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162229",
            "telephone_number": "773-575-0613",
            "fax_number": "847-299-7844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 WEST DEMPSTER STREET",
            "address_2": "SUITE #120",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "60068",
            "telephone_number": "847-299-7888",
            "fax_number": "847-299-7844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZAN",
        "first_name": "ANDREA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036095548",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-095548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-095548",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036095548",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abazan252317@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1600 West Dempster Street",
            "address_2": "Suite #120",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60068",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAUROR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1600 West Dempster Street",
            "address_2": "Suite #120",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emma Dineen Bauer
• Jerry Bauer, MD
• Leah Baumgart, MS, CF-SLP
• Swati Bavisi, RN, MS, CPNP, APN
• Ronna Bayot, PT
• Be Well Stay Well Counseling LLC
• Suri M Becker-Jata, MS, CCC-SLP
• Howard Stephen Becker, MD
• Kelly Becker
• Karen Beckstrand, PSYD

• Internal Medicine Physician in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.