Individual provider Active NPI

Victor Mategrano, MD

  • Diagnostic Radiology Physician
  • Schaumburg, IL
National Provider Identifier
1790708378
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Practice address
1834 Walden Office SQ
#125 Oamri of Schaumburg LLC
Schaumburg, IL 60173
Phone
(847) 397-2300
Fax
(847) 397-6140
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X IL Primary

Addresses

Primary practice location

1834 Walden Office SQ
#125 Oamri of Schaumburg LLC
Schaumburg, IL 60173

Mailing address

1126 S 70TH St
Suite N500
Milwaukee, WI 53214
Phone (414) 455-4780

Other identifiers 1

IdentifierTypeStateIssuer
1376728105OtherILNPI NEW CORP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-047699ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Radiologists, S.C. Diagnostic Radiology PastSince Sep 15, 2019 Accepting new patients
Premier Health Services Inc PastSince Nov 24, 2007 Accepting new patients

Organizations & group practices 2

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1790708378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 S 70TH ST",
            "address_2": "SUITE N500",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53214",
            "telephone_number": "414-455-4780",
            "fax_number": "414-475-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1834 WALDEN OFFICE SQ",
            "address_2": "#125 OAMRI OF SCHAUMBURG LLC",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "60173",
            "telephone_number": "847-397-2300",
            "fax_number": "847-397-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEGRANO",
        "first_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NEW CORP",
            "identifier": "1376728105",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.