Individual provider Active NPI

Carlos Becerra-Meneses, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1902623549
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209.030927 Issued in IL
Practice address
1127 N Oakley Blvd FL 3
Chicago, IL 60622-3507
Phone
(312) 770-3320
Fax
(312) 770-2557
NPI assigned
Sep 24, 2024
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209.030927 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1127 N Oakley Blvd FL 3
Chicago, IL 60622-3507

Mailing address

1520 W Harrison St FL 7
Chicago, IL 60607-3106
Phone (312) 942-4500

Other practice location 1

1520 W Harrison St Fl 7
Chicago, IL 60607-3106
Phone (312) 942-4500

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260226002073 IL Practitioner - Nurse Practitioner 7517448616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Rush Medical College of Rush University, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3480 E Guasti Rd
Ontario, CA 91761-7684

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.030927ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare Illinois Medical Group LLC CurrentSince Jan 17, 2026 Accepting new patients

Locations

1801 W Olympic Blvd
#2636
Pasadena, CA 91199

1325 N Highland Ave
Aurora, IL 60506
Phone (630) 801-2756

100 Provena Way
Ste 103
Bourbonnais, IL 60914
Phone (815) 937-8780

1127 N Oakley Blvd
Fl 3
Chicago, IL 60622
Phone (312) 770-2317

100 N River Rd
Des Plaines, IL 60016
Phone (847) 297-1800

201 N Hammes Ave
Joliet, IL 60435
Phone (224) 273-6350

Organizations & group practices 1

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 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": "1727136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1902623549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 W HARRISON ST FL 7",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073106",
            "telephone_number": "312-942-4500",
            "fax_number": "312-942-2380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 N OAKLEY BLVD FL 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223507",
            "telephone_number": "312-770-3320",
            "fax_number": "312-770-2557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 W Harrison St Fl 7",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606073106",
            "country_code": "US",
            "telephone_number": "312-942-4500",
            "fax_number": "312-942-2380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BECERRA-MENESES",
        "first_name": "CARLOS",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.030927",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.