NPIMap

Organization Active NPI

Andina & Irabagon, S.C.

  • Cardiovascular Disease Physician
  • Oak Lawn, IL
National Provider Identifier
1972520542
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
ANDINA & IRABAGON, S.C.
Doing business as
Andina & Irabagon, S.C.
Practice address
5702 W 95TH St
Oak Lawn, IL 60453-2345
Phone
(773) 581-8400
Fax
(773) 581-9577
NPI assigned
Jul 17, 2006
Last updated
Jun 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Robert J Andina, MDNPI 1346235280
Title
President
Phone
(773) 519-3132

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary

Addresses

Primary practice location

5702 W 95TH St
Oak Lawn, IL 60453-2345

Mailing address

PO Box 95
Orland Park, IL 60462-0095
Phone (708) 218-3033

Other names 1

  • Andina & Irabagon, S.C. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060817000568 IL Part B Supplier - Clinic/Group Practice 1456354109 Receives reassigned benefits from 2 practitioners
Practice locations: Oak Lawn, IL

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDJIAA

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1972520542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604620095",
            "telephone_number": "708-218-3033",
            "fax_number": "773-581-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5702 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532345",
            "telephone_number": "773-581-8400",
            "fax_number": "773-581-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDINA & IRABAGON, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "ANDINA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-519-3132",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Andina & Irabagon, S.C.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Andina & Irabagon, S.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.