Individual provider Active NPI

Brian Kurtz, DO

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1831469253
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.135878 Issued in IL
Practice address
4318 S State St
Chicago, IL 60609-3701
Phone
(773) 285-9304
Fax
(773) 564-3501
NPI assigned
Jan 2, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.135878 IL Primary

Addresses

Primary practice location

4318 S State St
Chicago, IL 60609-3701

Mailing address

213 N Racine Ave
Suite 100
Chicago, IL 60607-1644
Phone (312) 733-9730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20181016002390 PA Practitioner - Internal Medicine 8628224417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osh - PA Physicians Group, PCGroup PAC ID 7517213879, 113 clinicians

Practice addresses (Care Compare)

5050 Parkside Ave
Philadelphia, PA 19131-4714
Phone (312) 600-8484

Hospital & facility affiliations

  • Penn Medicine Home Health Home health agency, Bala Cynwyd, PA, CCN 397125
  • Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223
  • Glendale Home-Schdy Cnty Dept Social Services Nursing home, Scotia, NY, CCN 335252

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.135878ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osh - PA Physicians Group, PC Internal Medicine CurrentSince Sep 26, 2018 Accepting new patients
Schenectady County Past Accepting new patients
Oak Street Physician Services LLC Internal Medicine Past Accepting new patients

Locations

30 W Monroe St
Ste 1200
Chicago, IL 60603
Phone (773) 609-1758

5050 Parkside Ave
Philadelphia, PA 19131
Phone (215) 390-1742

3621 Aramingo Ave
Philadelphia, PA 19134
Phone (312) 600-8484

Organizations & group practices 3

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 4

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": "1325462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1831469253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 N RACINE AVE",
            "address_2": "SUITE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071644",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 S STATE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606093701",
            "telephone_number": "773-285-9304",
            "fax_number": "773-564-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURTZ",
        "first_name": "BRIAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-02",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.135878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.