Individual provider Active NPI

Edmund B. Mangahas, M.D.

  • Anesthesiology Physician
  • Chicago, IL
National Provider Identifier
1871540443
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036106222 Issued in IL
Practice address
1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone
(312) 942-3138
Fax
(312) 942-5773
NPI assigned
May 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036106222 IL Primary
Interventional Pain Medicine Physician 208VP0014X 036106222 IL

Addresses

Primary practice location

1653 W Congress Pkwy
Chicago, IL 60612-3833

Mailing address

1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone (312) 942-3138

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
I20060120000056 IL Practitioner - Anesthesiology 4183648926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Anesthesiologists SCGroup PAC ID 4183512080, 152 clinicians

Practice addresses (Care Compare)

1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone (312) 942-3138

Hospital & facility affiliations

  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036106222ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Anesthesiologists SC Anesthesiology CurrentSince Apr 1, 2009 Accepting new patients
Advocate Southwest Ambulatory Surgery Center LLC Anesthesiology Past Accepting new patients

Locations

1725 W Harrison St
Ste 556
Chicago, IL 60612
Phone (312) 563-2880

1653 W Congress Pkwy
#739
Chicago, IL 60612
Phone (312) 942-3138

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

520 S Maple Ave
Oak Park, IL 60304
Phone (708) 383-9300

Organizations & group practices 2

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 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": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1871540443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-3138",
            "fax_number": "312-942-5773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-3138",
            "fax_number": "312-942-5773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGAHAS",
        "first_name": "EDMUND",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036106222",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "036106222",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.