Individual provider Active NPI

Nidal Elbaridi, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Chicago, IL
National Provider Identifier
1780821264
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
036134543 Issued in IL
Practice address
1921 S Michigan Ave
Chicago, IL 60616-1603
Phone
(312) 414-1088
Fax
(312) 920-1799
NPI assigned
Jan 20, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036134543 IL
Anesthesiology Physician 207L00000X 261710 MA
Anesthesiology Physician 207L00000X 66155-20 WI
Physical Therapist 225100000X 05005794A IN
Pain Medicine (Anesthesiology) Physician 207LP2900X 036134543 IL Primary

Addresses

Primary practice location

1921 S Michigan Ave
Chicago, IL 60616-1603

Mailing address

1921 S Michigan Ave
Chicago, IL 60616-1603
Phone (312) 414-1088

Other identifiers 1

IdentifierTypeStateIssuer
036134543MedicaidIL

Other names 1

  • Dr. Nick Elbaridi Professional name

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
I20161229001609 IL Practitioner - Pain ManagementPractitioner - Anesthesiology 7214992957 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Insight Chicago IncGroup PAC ID 2860894706, 140 clinicians

Practice addresses (Care Compare)

1921 S Michigan Ave
Chicago, IL 60616-1603
Phone (312) 414-1088

2525 S Michigan Ave
Chicago, IL 60616-2315
Phone (708) 382-1498

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
261710MAMDAnesthesiology Physician
66155-20WIMDAnesthesiology Physician
05005794AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Chicago, Inc. CurrentSince Oct 7, 2024 Accepting new patients
Swedish Covenant Management Services, Inc CurrentSince Feb 1, 2017 Accepting new patients
Professional Anesthesiology Interventional Network, Inc Anesthesiology CurrentSince Nov 30, 2016 Accepting new patients
Insight Chicago, Inc. Anesthesiology CurrentSince Oct 7, 2024 Accepting new patients
Swedish Covenant Management Services, Inc. CurrentSince Feb 1, 2017 Accepting new patients
Indy Physical Therapy, P.C. Physical Therapist Past Accepting new patients
Indy Physical Therapy Physical Therapist Past Accepting new patients

Locations

2525 S Michigan Ave
Chicago, IL 60616
Phone (312) 355-1153

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

1921 S Michigan Ave
Chicago, IL 60616
Phone (312) 328-9220

Organizations & group practices 7

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 1

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": "1232409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1780821264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606161603",
            "telephone_number": "312-414-1088",
            "fax_number": "312-920-1799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606161603",
            "telephone_number": "312-414-1088",
            "fax_number": "312-920-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELBARIDI",
        "first_name": "NIDAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-20",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036134543",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "261710",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "66155-20",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05005794A",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036134543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036134543",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICK",
            "last_name": "ELBARIDI",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.