Individual provider Active NPI

Harold Bregman, M.D.

  • Nephrology Physician
  • Park Ridge, IL
National Provider Identifier
1952381253
Registry record updated Dec 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036066587 Issued in IL
Practice address
1550 Northwest Highway
Suite 303
Park Ridge, IL 60068-1460
Phone
(847) 294-5160
Fax
(847) 294-9962
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 036066587 IL Primary

Addresses

Primary practice location

1550 Northwest Highway
Suite 303
Park Ridge, IL 60068-1460

Mailing address

210 S Desplaines St
Chicago, IL 60661-5500
Phone (312) 654-2700

Other identifiers 1

IdentifierTypeStateIssuer
036066587MedicaidIL

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
I20040202000521 IL Practitioner - NephrologyPractitioner - Internal Medicine 8729982418

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036066587ILMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fresenius Medical Care Chicagoland, LLC PastSince Sep 1, 2013 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451520000000",
    "number": "1952381253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S DESPLAINES ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606615500",
            "telephone_number": "312-654-2700",
            "fax_number": "312-654-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 NORTHWEST HIGHWAY",
            "address_2": "SUITE 303",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681460",
            "telephone_number": "847-294-5160",
            "fax_number": "847-294-9962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREGMAN",
        "first_name": "HAROLD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2015-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036066587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036066587",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.