Individual provider Active NPI

Claudia A Roldan, FNP

  • Family Nurse Practitioner
  • Berwyn, IL
National Provider Identifier
1801557319
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209024752 Issued in IL
Practice address
2550 Oak Park Ave
Berwyn, IL 60402-4661
Phone
(708) 575-6757
Fax
(877) 653-2695
NPI assigned
Jan 6, 2022
Last updated
Sep 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209024752 IL Primary
Critical Care Medicine Registered Nurse 163WC0200X 041400346 IL

Addresses

Primary practice location

2550 Oak Park Ave
Berwyn, IL 60402-4661

Mailing address

1736 N Washtenaw Ave
Chicago, IL 60647-0724
Phone (773) 443-5156

Other identifiers 2

IdentifierTypeStateIssuer
041400436OtherILIDFPR
209024752OtherILIDFPR

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220401002125 IL Practitioner - Nurse Practitioner 8628464575 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041400346ILMDCritical Care Medicine Registered Nurse
209024752ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Management Services, LTD. CurrentSince Sep 1, 2022 Accepting new patients

Locations

1375 E Schaumburg Rd
Ste 100
Schaumburg, IL 60194
Phone (847) 891-6850

Interoperability endpoints

  • Direct secure messaging: claudia.roldan.p1@direct.alegiscare.nextgenshare.com
  • Direct secure messaging: claudia.roldan.p2@direct.alegiscare.nextgenshare.com

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, 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": "1641427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1801557319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1736 N WASHTENAW AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606470724",
            "telephone_number": "773-443-5156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604024661",
            "telephone_number": "708-575-6757",
            "fax_number": "877-653-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLDAN",
        "first_name": "CLAUDIA",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-06",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209024752",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "IL",
            "license": "041400346",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDFPR",
            "identifier": "041400436",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDFPR",
            "identifier": "209024752",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.