Individual provider Active NPI

Tatiana A Batista, DO

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1972612760
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036113050 Issued in IL
Practice address
5346 N Clark St
Chicago, IL 60640-2120
Phone
(773) 293-8880
Fax
(773) 293-8843
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036113050 IL Primary

Addresses

Primary practice location

5346 N Clark St
Chicago, IL 60640-2120

Mailing address

1656 N Wells
Chicago, IL 60614
Phone (312) 643-1333

Other practice location 1

1656 N Wells
Chicago, IL 60614
Phone (312) 643-1333

Other identifiers 2

IdentifierTypeStateIssuer
036113050OtherILIL LICENSE #
036113050MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tbatista277045@direct.northshore.org

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
I20050726000894 IL Practitioner - Family Practice 8921035478 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Covenant Management Services, Inc CurrentSince May 1, 2019 Accepting new patients
Swedish Covenant Management Services, Inc. Family Medicine CurrentSince May 1, 2019 Accepting new patients
Endeavor Health Medical Group PastSince May 3, 2020 Accepting new patients
Endeavor Health Medical Group Family Medicine PastSince May 3, 2020 Accepting new patients

Locations

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

2740 W Foster Ave
Ste 310
Chicago, IL 60625

Organizations & group practices 4

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1972612760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1656 N WELLS",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60614",
            "telephone_number": "312-643-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5346 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402120",
            "telephone_number": "773-293-8880",
            "fax_number": "773-293-8843"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1656 N Wells",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60614",
            "country_code": "US",
            "telephone_number": "312-643-1333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BATISTA",
        "first_name": "TATIANA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2025-05-19",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036113050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL LICENSE #",
            "identifier": "036113050",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036113050",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbatista277045@direct.northshore.org",
            "affiliation": "N",
            "address_1": "5346 N Clark St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606402120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.