Individual provider Active NPI

Alexander Mazur, MD

  • Clinical Cardiac Electrophysiology Physician
  • Chicago, IL
National Provider Identifier
1710172515
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
036123579 Issued in IL
Practice address
1725 W Harrison St Ste 1159
Chicago, IL 60612-3883
Phone
(312) 942-5020
NPI assigned
Sep 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 37476 IA
Cardiovascular Disease Physician 207RC0000X 37476 IA
Interventional Cardiology Physician 207RI0011X 37476 IA
Clinical Cardiac Electrophysiology Physician 207RC0001X 37476 IA
Clinical Cardiac Electrophysiology Physician 207RC0001X 036123579 IL Primary

Addresses

Primary practice location

1725 W Harrison St Ste 1159
Chicago, IL 60612-3883

Mailing address

1725 W Harrison St Ste 1159
Chicago, IL 60612-3883
Phone (312) 942-5020

Other practice location 1

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-2706

Other identifiers 1

IdentifierTypeStateIssuer
71363OtherIAWELLMARK BCBS

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
I20091221000510 IL Practitioner - Cardiac ElectrophysiologyPractitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 3577644749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Internal Medicine
Education
Other, 1983
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)

1725 W Harrison St
Suite 1159
Chicago, IL 60612-3883
Phone (312) 942-5020

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37476IAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Internal Medicine CurrentSince Jun 1, 2022 Accepting new patients
Rush University Medical Center Internal Medicine CurrentSince Jun 1, 2022 Accepting new patients

Locations

1725 W Harrison St
Ste 358
Chicago, IL 60612
Phone (312) 563-5020

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

1725 W Harrison St
Ste 1159
Chicago, IL 60612
Phone (312) 942-5020

75 Remittance Dr
Dept 1611
Chicago, IL 60675

2011 York Rd
Fl 5
Oak Brook, IL 60523

2011 York Rd
Ste 2000A
Oak Brook, IL 60523
Phone (312) 947-7546

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1710172515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 1159",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123883",
            "telephone_number": "312-942-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 1159",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123883",
            "telephone_number": "312-942-5020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawkins Dr",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421009",
            "country_code": "US",
            "telephone_number": "319-356-2706",
            "fax_number": "319-353-6343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZUR",
        "first_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-14",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "37476",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IA",
            "license": "37476",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IA",
            "license": "37476",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "IA",
            "license": "37476",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "IL",
            "license": "036123579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "71363",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.