Individual provider Active NPI

Angel M Garcia Otano, MD

  • Family Medicine Physician
  • Naperville, IL
National Provider Identifier
1992904221
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.125928 Issued in IL
Practice address
2940 Rollingridge Rd
Suite 100
Naperville, IL 60564-4231
Phone
(630) 646-5800
NPI assigned
Jul 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 39177 IA
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 036.125928 IL Primary

Addresses

Primary practice location

2940 Rollingridge Rd
Suite 100
Naperville, IL 60564-4231

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address agarciaotano120202@dulyhealthandcare.direct-ci.com

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
I20160825002843 IL Practitioner - Family Practice 8224220405 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

76 W Countryside Pkwy
Yorkville, IL 60560-1967
Phone (630) 553-2722

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39177IAMDFamily Medicine Physician
036.125928ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Feb 1, 2024 Accepting new patients
Dupage Medical Group LTD CurrentSince Aug 8, 2016 Accepting new patients
Endeavor Health Medical Group Family Medicine CurrentSince Feb 1, 2024 Accepting new patients
Dupage Medical Group LTD CurrentSince Aug 8, 2016 Accepting new patients
North Iowa Mercy Clinics Family Medicine Past Accepting new patients
Floyd County Memorial Hospital Commission Family Medicine Past Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2940 Rollingridge Rd
Ste 100
Naperville, IL 60564
Phone (630) 369-4771

2940 Rollingridge Rd
Ste 300
Naperville, IL 60564
Phone (630) 646-5800

Interoperability endpoints

  • Direct secure messaging: agarciaotano120202@dulyhealthandcare.direct-ci.com
  • Direct secure messaging: agarciaotano120202@direct.edward.org

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1992904221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 ROLLINGRIDGE RD",
            "address_2": "SUITE 100",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605644231",
            "telephone_number": "630-646-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA OTANO",
        "first_name": "ANGEL",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "39177",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.125928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agarciaotano120202@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "2940 Rollingridge Rd",
            "address_2": "SUITE 100",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605644231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.