Active NPI
Fernando A Ampuero, MD
- Gynecology Physician
- Chicago, IL
National Provider Identifier
1760438477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 036066158
- Practice address
- 3517 W 26TH St
Chicago, IL 60623-3910 - Phone
- (773) 521-6001
- Fax
- (773) 521-1154
- NPI assigned
- May 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 036066158 | IL | Primary |
Addresses
Primary practice location
3517 W 26TH St
Chicago, IL 60623-3910
Mailing address
PO Box 6811
Chicago, IL 60680-6811
Phone (773) 521-6001
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Other, 1974
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
645 S Central Ave
Chicago, IL 60644-5059
Phone (773) 854-5567
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036066158 | IL | MD | Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Loretto Hospital | Current | Accepting new patients |
Locations
645 S Central Ave
Chicago, IL 60644
Phone (773) 626-4300
Interoperability endpoints
- fernando.ampuero@loretto.medalliesdirect.net
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1447280284
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414108800000",
"number": "1760438477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6811",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606806811",
"telephone_number": "773-521-6001",
"fax_number": "773-521-1154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3517 W 26TH ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606233910",
"telephone_number": "773-521-6001",
"fax_number": "773-521-1154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMPUERO",
"first_name": "FERNANDO",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-25",
"last_updated": "2014-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "IL",
"license": "036066158",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; 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.