Individual provider Active NPI

Harold Jaimes, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1770526279
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036088816 Issued in IL
Practice address
3153 W Fullerton Ave
Chicago, IL 60647-2809
Phone
(773) 395-4600
Fax
(773) 395-4633
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036088816 IL Primary

Addresses

Primary practice location

3153 W Fullerton Ave
Chicago, IL 60647-2809

Mailing address

3153 W Fullerton Ave
Chicago, IL 60647-2809
Phone (773) 395-4600

Other identifiers 3

IdentifierTypeStateIssuer
036088816MedicaidIL
110141147OtherILRAILROAD MEDICARE
1605620OtherILBLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, FL2 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
I20041030000063 IL Practitioner - Internal Medicine 1456313600 Reassigns benefits to 1 organization
I20140317001943 FL Practitioner - Internal Medicine 1456313600 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Harold Jaimes, M.D. P.CGroup PAC ID 3274595426, 2 clinicians
Vitalmd Group Holding LLCGroup PAC ID 8921091786, 535 clinicians

Practice addresses (Care Compare)

3153 W Fullerton Ave
Chicago, IL 60647-2809
Phone 7733954600100

3225 Aviation Ave
Suite 700
Miami, FL 33133-4741
Phone (305) 273-4641

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal66

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalmd Group Holding LLC Internal Medicine CurrentSince Aug 3, 2018 Accepting new patients
Harold Jaimes, M.D. P.C Internal Medicine CurrentSince Jan 1, 2005 Accepting new patients
Norman Minars, MD, PA Past Accepting new patients

Locations

4060 Sheridan St
Ste C
Hollywood, FL 33021
Phone (954) 987-6200

3225 Aviation Ave
Ste 700
Miami, FL 33133
Phone (305) 273-4641

6342 S Pulaski Rd
Chicago, IL 60629
Phone (773) 284-8601

3153 W Fullerton Ave
Chicago, IL 60647
Phone (773) 278-6604

3800 Highland Ave
Ste 111
Downers Grove, IL 60515
Phone (630) 241-3779

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 3

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1770526279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3153 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472809",
            "telephone_number": "773-395-4600",
            "fax_number": "773-395-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3153 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472809",
            "telephone_number": "773-395-4600",
            "fax_number": "773-395-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIMES",
        "first_name": "HAROLD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036088816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088816",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110141147",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1605620",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.