Individual provider Active NPI

Raymond Vincent Garay

  • Critical Care Neonatal Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1912516667
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
209.021722 Issued in IL
Practice address
1620 W Harrison St
Chicago, IL 60612-3801
Phone
(888) 352-7874
NPI assigned
Jul 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X 209.021722 IL Primary

Addresses

Primary practice location

1620 W Harrison St
Chicago, IL 60612-3801

Mailing address

1264 Village Centre Dr Unit 5
Kenosha, WI 53144-7254
Phone (262) 705-1662

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
I20200908000012 IL Practitioner - Nurse Practitioner 7315364387 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.021722ILMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Center CurrentSince Aug 31, 2020 Accepting new patients
Rush University Medical Group CurrentSince Aug 31, 2020 Accepting new patients
Lurie Children'S Medical Group, LLC Past Accepting new patients

Locations

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1725 W Harrison St
Ste 710
Chicago, IL 60612
Phone (312) 942-5983

1620 W Harrison St
Chicago, IL 60612
Phone (312) 942-4200

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

1653 W Congress Pkwy
#8
Chicago, IL 60612
Phone (847) 707-1674

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1653 W Congress Pkwy
Ste 8
Chicago, IL 60612

Interoperability endpoints

  • Direct secure messaging: rgaray170238@direct.rush.rush-health.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1912516667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1264 VILLAGE CENTRE DR UNIT 5",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531447254",
            "telephone_number": "262-705-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123801",
            "telephone_number": "888-352-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARAY",
        "first_name": "RAYMOND",
        "middle_name": "VINCENT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-29",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "IL",
            "license": "209.021722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.