Individual provider Active NPI

Luis Eduardo Rosas-Vidal, M.D.,PHD

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1851745269
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036161590 Issued in IL
Practice address
676 N Saint Clair St Ste 1100
Chicago, IL 60611-2954
Phone
(312) 695-5060
Fax
(312) 695-5010
NPI assigned
Apr 21, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 61478 TN
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 036161590 IL Primary

Addresses

Primary practice location

676 N Saint Clair St Ste 1100
Chicago, IL 60611-2954

Mailing address

676 N Saint Clair St Ste 1100
Chicago, IL 60611-2954
Phone (312) 695-5060

Other practice location 1

3601The Vanderbilt Clinic
Nashville, TN 37232-3196
Phone (615) 936-2000

Other practice location 2

1601 23rd Ave S Ste 3104
Psychiatry, Vanderbilt University Medical Center
Nashville, TN 37212-3196
Phone (615) 327-7119

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lrosasvidal32277@direct.vumc.org Direct

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
I20220916000807 IL Practitioner - Psychiatry 0244523694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Puerto Rico School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

676 N Saint Clair St
Suite 1100
Chicago, IL 60611-2954
Phone (312) 695-5060

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036161590ILMDPsychiatry Physician
61478TNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2022 Accepting new patients
Vanderbilt University PastSince Jul 1, 2020 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

676 N Saint Clair St
Ste 1100
Chicago, IL 60611

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Interoperability endpoints

  • Direct secure messaging: lrosasvidal32277@direct.vumc.org

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 1

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": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1851745269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 1100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112954",
            "telephone_number": "312-695-5060",
            "fax_number": "312-695-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 1100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112954",
            "telephone_number": "312-695-5060",
            "fax_number": "312-695-5010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601The Vanderbilt Clinic",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372323196",
            "country_code": "US",
            "telephone_number": "615-936-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1601 23rd Ave S Ste 3104",
            "address_2": "Psychiatry, Vanderbilt University Medical Center",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372123196",
            "country_code": "US",
            "telephone_number": "615-327-7119",
            "fax_number": "615-327-7136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSAS-VIDAL",
        "first_name": "LUIS",
        "middle_name": "EDUARDO",
        "name_prefix": "Dr.",
        "credential": "M.D.,PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-21",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "61478",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036161590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lrosasvidal32277@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "3601The Vanderbilt Clinic",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372323196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.