Individual provider Active NPI

Katie Lynn Mena, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1790001329
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.131369 Issued in IL
Practice address
1740 W Taylor St
Ste 3Aa
Chicago, IL 60612-7232
Phone
(866) 600-2273
NPI assigned
Apr 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.131369 IL Primary
Pediatrics Physician 208000000X 036.131369 IL

Addresses

Primary practice location

1740 W Taylor St
Ste 3Aa
Chicago, IL 60612-7232

Mailing address

1812 S State Street
Unit 11
Chicago, IL 60616
Phone (312) 623-2061

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
I20141021002105 IL Practitioner - Pediatric MedicinePractitioner - Interventional Pain Management 5395966048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Interventional Pain Management
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, 1,134 clinicians

Practice addresses (Care Compare)

840 S Wood St MC
787 Uic Medicine
Chicago, IL 60612-4325
Phone (312) 413-8687

Hospital & facility affiliations

  • Tru-Care Home Health, Inc Home health agency, Chicago, IL, CCN 148002
  • Global Home Health, LLC Home health agency, Oak Park, IL, CCN 148387
  • University of Illinois Hospital and Clinics Hospital, Chicago, IL, CCN 140150

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.131369ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois Internal Medicine CurrentSince Aug 16, 2014 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Aug 16, 2014 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Board of Trustees of the University of Illinois Internal Medicine Past Accepting new patients

Locations

1740 W Taylor St
Ste 3AA
Chicago, IL 60612

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

840 S Wood St
#787
Chicago, IL 60612
Phone (312) 413-8687

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

1801 W Taylor St
Chicago, IL 60612
Phone (312) 355-1700

840 S Wood St
#856
Chicago, IL 60612
Phone (312) 413-1429

7732 Solutions Ctr
Chicago, IL 60677

845 W Wilson Ave
Chicago, IL 60640
Phone (312) 744-1295

Interoperability endpoints

  • Direct secure messaging: kmena17290@uihealth.direct-ci.com

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 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": "1270598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1790001329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 S STATE STREET",
            "address_2": "UNIT 11",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60616",
            "telephone_number": "312-623-2061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "address_2": "STE 3AA",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "866-600-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENA",
        "first_name": "KATIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-07",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.131369",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.131369",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.