Individual provider Active NPI

Heliodoro Medina, MD

  • Gastroenterology Physician
  • Geneva, IL
National Provider Identifier
1740267756
Registry record updated Mar 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036104186 Issued in IL
Practice address
302 Randall Rd
Geneva, IL 60134-4220
Phone
(630) 262-7400
Fax
(630) 262-3760
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036104186 IL Primary

Addresses

Primary practice location

302 Randall Rd
Geneva, IL 60134-4220

Mailing address

302 Randall Rd
Geneva, IL 60134-4220
Phone (630) 262-7400

Other identifiers 5

IdentifierTypeStateIssuer
F400100146OtherILMEDICARE PTAN (INDIVIDUAL)
036100061MedicaidIL
CA4748OtherILRAILROAD MEDICARE (GROUP PTAN)
P01248201OtherILRAILROAD MEDICARE (PROVIDER PTAN)
206147OtherILMEDICARE PTAN (GROUP)

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
I20050601000120 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 0345282349 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

302 Randall Rd
Suite 105
Geneva, IL 60134-4219
Phone (630) 352-5450

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy176
Upper gastrointestinal (GI) endoscopy for acid reflux221

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036104186ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Oct 1, 2013 Accepting new patients
Central Dupage Physician Group CurrentSince Oct 1, 2013 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 14, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 14, 2023 Accepting new patients
Gastroenterology Group Practice, LLC Gastroenterology PastSince Aug 1, 2009 Accepting new patients

Locations

501 Thornhill Dr
Ste 105
Carol Stream, IL 60188
Phone (630) 262-7400

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

302 Randall Rd
Ste 105
Geneva, IL 60134
Phone (630) 232-0202

302 Randall Rd
Ste 210
Geneva, IL 60134
Phone (630) 232-7300

302 Randall Rd
Geneva, IL 60134
Phone (630) 208-6775

302 Randall Rd
Ste 303
Geneva, IL 60134
Phone (630) 262-7400

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

311 S County Farm Rd
Ste B
Wheaton, IL 60187
Phone (630) 580-9776

25 N Winfield Rd
Ste 420
Winfield, IL 60190
Phone (630) 262-7400

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 4

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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425427200000",
    "number": "1740267756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 RANDALL RD",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344220",
            "telephone_number": "630-262-7400",
            "fax_number": "630-262-3760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 RANDALL RD",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344220",
            "telephone_number": "630-262-7400",
            "fax_number": "630-262-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "HELIODORO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2015-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036104186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "F400100146",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100061",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE (GROUP PTAN)",
            "identifier": "CA4748",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE (PROVIDER PTAN)",
            "identifier": "P01248201",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (GROUP)",
            "identifier": "206147",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

Verify at the official NPI Registry.