Individual provider Active NPI

Andres Luis Marius-Nunez, M.D.

  • Specialist
  • Berwyn, IL
National Provider Identifier
1770680431
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
036077902 Issued in IL
Practice address
7036 Cermak Rd
Berwyn, IL 60402-2197
Phone
(708) 484-9145
Fax
(708) 484-0441
NPI assigned
Sep 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 036077902 IL Primary

Addresses

Primary practice location

7036 Cermak Rd
Berwyn, IL 60402-2197

Mailing address

7036 Cermak Rd
Berwyn, IL 60402-2197
Phone (708) 484-9145

Other identifiers 2

IdentifierTypeStateIssuer
1607253OtherILBCBS OF ILLINOIS
036077902MedicaidIL

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
I20051230000237 IL Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 3476575895 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Marius-Nunez Medical Group S C Single Specialty CurrentSince Mar 1, 1996 Accepting new patients

Locations

7036 Cermak Rd
Berwyn, IL 60402
Phone (708) 484-9145

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1770680431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7036 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022197",
            "telephone_number": "708-484-9145",
            "fax_number": "708-484-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7036 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022197",
            "telephone_number": "708-484-9145",
            "fax_number": "708-484-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIUS-NUNEZ",
        "first_name": "ANDRES",
        "middle_name": "LUIS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036077902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "1607253",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036077902",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.