Individual provider Active NPI

Monica Medrano, MD, MS

  • Family Medicine Physician
  • Michigan City, IN
National Provider Identifier
1821655663
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01088219A Issued in IN
Practice address
3012 Franklin St
Michigan City, IN 46360-6144
Phone
(219) 877-3841
NPI assigned
May 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036.158389 IL
Family Medicine Physician 207Q00000X 01088219A IN Primary

Addresses

Primary practice location

3012 Franklin St
Michigan City, IN 46360-6144

Mailing address

2508 N Ashland Ave # 2F
Chicago, IL 60614-2004
Phone (773) 807-1110

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
I20220721002687 IL Practitioner - Family Practice 4082949433 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 2019
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Midwest Wound Care IncorporatedGroup PAC ID 3173052719, 2 clinicians
Innovative Platinum Care, SCGroup PAC ID 7012210461, 19 clinicians

Practice addresses (Care Compare)

1190 Lily Cache LN
Apt 103
Bolingbrook, IL 60490-3284
Phone (630) 755-1695

2363 N California Ave
Chicago, IL 60647-2939
Phone (773) 278-7024

2400 N Ashland Ave
Chicago, IL 60614-0851
Phone (773) 270-5600

2400 N Ashland Ave
Suite 150
Chicago, IL 60614-2021

2418 N Ashland Ave
Chicago, IL 60614-2021
Phone (773) 900-8330

742 W Diversey Pkwy
Chicago, IL 60614-1550
Phone (773) 261-8300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.158389ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Wound Care Incorporated CurrentSince Dec 23, 2024 Accepting new patients
Housecalls Done Wright LTD CurrentSince Jul 1, 2022 Accepting new patients
Innovative Platinum Care, SC Family Medicine CurrentSince Mar 1, 2023 Accepting new patients
Innovative Medspa PLLC PastSince Jun 2, 2024 Accepting new patients

Locations

2400 N Ashland Ave
Chicago, IL 60614
Phone (773) 259-7180

4021 W 63rd St
Ste C
Chicago, IL 60629
Phone (312) 504-3277

1253 N Milwaukee Ave
Chicago, IL 60622
Phone (773) 435-8247

2418 N Ashland Ave
Chicago, IL 60614
Phone (773) 799-8045

Interoperability endpoints

  • Direct secure messaging: monica.medrano.1@33292.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/4021/brand/1/csg/1/fhir/r4
  • Direct secure messaging: monica.medrano.1@13676.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1821655663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 N ASHLAND AVE # 2F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606142004",
            "telephone_number": "773-807-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3012 FRANKLIN ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463606144",
            "telephone_number": "219-877-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDRANO",
        "first_name": "MONICA",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-28",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.158389",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01088219A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.