Avery Scott Hart, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036078737 Issued in IL

Practice address

1285 Hartrey Ave
Erie Evanston/Skokie Health Center
Evanston, IL 60202-1056

Phone

(847) 666-3494

Fax

(847) 868-8964

NPI assigned

Jun 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Mount Sinai Hospital Medical Center

  • Psychiatric Hospital Unit
  • Chicago, IL
  • NPI 1518057769

  Corporate Officer

  CMS ownership
• Mount Sinai Hospital Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1871581314

  Corporate Officer

  CMS ownership

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.

• Erie Family Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1760499545
  Medicare reassignment NPD
• Erie Family Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1548062318
  NPD
• Erie Family Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1134316631
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411344000000",
    "number": "1831135102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 HARTREY AVE",
            "address_2": "ERIE EVANSTON/SKOKIE HEALTH CENTER",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021056",
            "telephone_number": "847-666-3494",
            "fax_number": "847-868-8964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 HARTREY AVE",
            "address_2": "ERIE EVANSTON/SKOKIE HEALTH CENTER",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021056",
            "telephone_number": "847-666-3494",
            "fax_number": "847-868-8964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "AVERY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2014-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036078737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363088628",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peonita Harris, M.A., LMFT
• Theodore R Harris, LCSW, CADC
• Zakiya Harris
• Ilana Harrow, LSW, PEL
• Harry J Jaffe, MD,SC
• Elizabeth Hart, M.P.T.
• Megan Jones Hart, OTR/L
• Sari L. Hart, MD
• Ciara Nicole Hartema
• Robert James Hartke, PH.D.

• Internal Medicine Physician in Evanston, IL
• Providers in Evanston, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.