Individual provider Active NPI

Dori Moscowitz, D.O.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1710349725
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036147513 Issued in IL
Practice address
1931 N Halsted St
Chicago, IL 60614-5008
Phone
(312) 998-5510
NPI assigned
Mar 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 036147513 IL Primary

Addresses

Primary practice location

1931 N Halsted St
Chicago, IL 60614-5008

Mailing address

181 W Madison St
Ste 3825
Chicago, IL 60602-4500
Phone (773) 975-1600

Other practice location 1

836 W Wellington Ave
Chicago, IL 60657-5147
Phone (773) 975-1600

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
I20190515001634 IL Practitioner - Family Practice 2466745195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
One Medical Group IncGroup PAC ID 2567623739, 330 clinicians

Practice addresses (Care Compare)

1931 N Halsted St
Chicago, IL 60614-5008
Phone (888) 663-6331

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
One Medical Group, Inc Family Medicine CurrentSince Nov 1, 2022 Accepting new patients
One Medical Group, Inc. Family Medicine CurrentSince Nov 1, 2022 Accepting new patients
Rush Oak Park Physicians Group Lake Street Family Medicine Past Accepting new patients

Locations

181 W Madison St
Ste 3825
Chicago, IL 60602
Phone (312) 999-5510

1931 N Halsted St
Chicago, IL 60614
Phone (312) 998-5510

730 Waukegan Rd
Deerfield, IL 60015

Organizations & group practices 3

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 1

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": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1710349725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 W MADISON ST",
            "address_2": "STE 3825",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606024500",
            "telephone_number": "773-975-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 N HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606145008",
            "telephone_number": "312-998-5510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "836 W Wellington Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575147",
            "country_code": "US",
            "telephone_number": "773-975-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSCOWITZ",
        "first_name": "DORI",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036147513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.