Individual provider Active NPI

Andrew Shabila, M.D.

  • Vascular & Interventional Radiology Physician
  • Skokie, IL
National Provider Identifier
1710398474
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
55269 Issued in KY
Practice address
9977 Woods Dr Ste B70
Skokie, IL 60077-1057
Phone
(847) 663-2661
NPI assigned
May 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 036143613 IL
Student in an Organized Health Care Education/Training Program 390200000X 036143613 IL
Vascular & Interventional Radiology Physician 2085R0204X 55269 KY Primary

Addresses

Primary practice location

9977 Woods Dr Ste B70
Skokie, IL 60077-1057

Mailing address

1128 Washington Blvd Apt 3a
Oak Park, IL 60302-3642
Phone (773) 987-7476

Other practice location 1

1901 W Harrison St Ste 2533
Chicago, IL 60612-3714
Phone (312) 864-3825

Other practice location 2

800 Rose St
Lexington, KY 40536-1057
Phone (859) 323-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170809000293 IL Practitioner - HospitalistPractitioner - Internal Medicine 4486954914 Reassigns benefits to 1 organization
I20220627001424 KY Practitioner - Interventional Radiology 4486954914 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentucky Medical Services Foundation, IncGroup PAC ID 5698689909, 949 clinicians

Practice addresses (Care Compare)

800 Rose St
Lexington, KY 40536-0001
Phone (859) 323-5000

Hospital & facility affiliations

  • University of Kentucky Hospital Hospital, Lexington, KY, CCN 180067

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
68.25
Promoting interoperability
100
Improvement activities
40
Cost
72.39

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Jul 15, 2017 Accepting new patients
The Metrohealth System Current Accepting new patients
Kentucky Medical Services Foundation, Inc CurrentSince Jul 1, 2022 Accepting new patients
Endeavor Health Medical Group CurrentSince Jul 15, 2017 Accepting new patients
University of Kentucky CurrentSince Jul 1, 2022 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

9977 Woods Dr
Ste B70
Skokie, IL 60077
Phone (847) 663-2661

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

Interoperability endpoints

  • Direct secure messaging: ashabila125389@ukhcdirect.org
  • Direct secure messaging: ashabila93220@direct.metrohealth.org

Organizations & group practices 5

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": "1400112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1710398474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1128 WASHINGTON BLVD APT 3A",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603023642",
            "telephone_number": "773-987-7476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR STE B70",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "847-663-2661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 W Harrison St Ste 2533",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123714",
            "country_code": "US",
            "telephone_number": "312-864-3825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Rose St",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405361057",
            "country_code": "US",
            "telephone_number": "859-323-2222",
            "fax_number": "859-323-5090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHABILA",
        "first_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-15",
        "last_updated": "2022-07-21",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036143613",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "036143613",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "KY",
            "license": "55269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.