Individual provider Active NPI

Sofia Amanda Garcia-Buder, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Chicago, IL
National Provider Identifier
1780622183
Registry record updated May 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036074618 Issued in IL
Practice address
2719 N Halsted St
C-1
Chicago, IL 60614-1413
Phone
(773) 388-5685
Fax
(773) 388-5687
NPI assigned
Jun 4, 2006
Last updated
May 3, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036074618 IL Primary

Addresses

Primary practice location

2719 N Halsted St
C-1
Chicago, IL 60614-1413

Mailing address

2719 N Halsted St
C-1
Chicago, IL 60614-1413
Phone (773) 388-5685

Other identifiers 3

IdentifierTypeStateIssuer
036074618MedicaidIL
01632690OtherILBCBSI
4315864OtherILCIGNA

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
I20110425000727 IL Practitioner - EndocrinologyPractitioner - Internal Medicine 1254516834 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036074618ILMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community First Healthcare of Illinois, Inc. CurrentSince Aug 1, 2016 Accepting new patients
Community First Healthcare of Illinois, Inc. Current Accepting new patients
Community First Healthcare of Illinois, Inc. CurrentSince Aug 1, 2016 Accepting new patients

Locations

5645 W Addison St
Chicago, IL 60634
Phone (773) 282-7000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304380800000",
    "number": "1780622183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2719 N HALSTED ST",
            "address_2": "C-1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141413",
            "telephone_number": "773-388-5685",
            "fax_number": "773-388-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2719 N HALSTED ST",
            "address_2": "C-1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141413",
            "telephone_number": "773-388-5685",
            "fax_number": "773-388-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA-BUDER",
        "first_name": "SOFIA",
        "middle_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2011-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036074618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036074618",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSI",
            "identifier": "01632690",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4315864",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.