Individual provider Active NPI

Arturo Olivera Jr., MD

  • Gastroenterology Physician
  • Chicago, IL
National Provider Identifier
1922097831
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036073024 Issued in IL
Practice address
3004 N Ashland Ave
Chicago, IL 60657-3012
Phone
(773) 871-4600
Fax
(773) 871-2900
NPI assigned
Oct 14, 2005
Last updated
Oct 12, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036073024 IL Primary

Addresses

Primary practice location

3004 N Ashland Ave
Chicago, IL 60657-3012

Mailing address

3004 N Ashland Ave
Chicago, IL 60657-3012
Phone (773) 871-4600

Other identifiers 3

IdentifierTypeStateIssuer
0001628796OtherILILLINOIS BCBS
036073024MedicaidIL
036073024OtherILSTATE OF ILLINOIS LICENSE

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
I20040525000760 IL Practitioner - Gastroenterology 2365423563 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Go Gastroenterology LTDGroup PAC ID 5991104804, 2 clinicians

Practice addresses (Care Compare)

3004 N Ashland Ave
Chicago, IL 60657-3012
Phone (773) 871-4600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.02 of 100Reported as group
Quality
83.14
Promoting interoperability
100
Improvement activities
40
Cost
62.56

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy168
Upper gastrointestinal (GI) endoscopy for acid reflux60

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Go Gastroenterology LTD Gastroenterology CurrentSince Jul 1, 2021 Accepting new patients
Sidney Hillman Health Centre of the Chicago and Cent St JNT BRD Union CurrentSince Jan 5, 2021 Accepting new patients

Locations

3004 N Ashland Ave
Chicago, IL 60657
Phone (773) 237-1122

333 S Ashland Ave
Chicago, IL 60607
Phone (312) 738-6170

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1922097831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573012",
            "telephone_number": "773-871-4600",
            "fax_number": "773-871-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573012",
            "telephone_number": "773-871-4600",
            "fax_number": "773-871-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVERA",
        "first_name": "ARTURO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036073024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS BCBS",
            "identifier": "0001628796",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036073024",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS LICENSE",
            "identifier": "036073024",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.