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MR. THEODISE HARRIS FNP-BC
NPI 1134716830
Nurse Practitioner - Family in Chicago, IL

Active since December 29, 2020PECOS EnrolledAccepts Medicare Assignment
77.13/100
CMS Quality Rating
2003 W FULTON ST, CHICAGO, IL 60612(312) 243-2223 Get Directions Write a Review

NPPES record last updated: March 28, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Theodise Harris Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. THEODISE HARRIS FNP-BC (NPI 1134716830) is an individual family provider in Chicago, Illinois, licensed in Illinois (209022572) and active in the NPI registry since December 2020. He is enrolled in Medicare PECOS, is affiliated with Northwest Community Hospital 1, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1134716830
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameMR. THEODISE HARRISCredential: FNP-BC
Location Address2003 W FULTON STChicago, IL 60612-2345
Mailing Address2003 W Fulton StChicago, IL 60612-2345 · (312) 243-2223 · Fax (312) 243-2227
Phone(312) 243-2223
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateDecember 29, 2020
Last NPPES UpdateMarch 28, 2022
NPPES CertifiedApril 21, 2021
✔ NPI 1134716830 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 209022572
2003 W FULTON ST, Chicago, IL 60612
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Theodise Harris Fnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2961811997
PECOS Enrollment IDI20210504001971, I20210628002760
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349
An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
976 services170 patients
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a G0179
This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.
158 services73 patients
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180
This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
111 services85 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
76 services76 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
71 services71 patients
Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes 99344
A new patient home visit is a comprehensive service where a healthcare professional visits your home for about an hour. This visit includes an overall health assessment, discussion about your medical history, and planning for future healthcare needs. The goal is to understand your health status and provide personalized care.
63 services63 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northwest Community Hospital 1

Acute Care Hospitals · Arlington Heights, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140252
Location800 W Central RoadArlington Heights, IL 60005 · Cook County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60612 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

77.13/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality80.91
Promoting Interoperability87
Improvement Activities40
Cost20.36

Reported Quality Measures

Breast Cancer Screening
0%95 patients1/55-star benchmark: 93%
Cervical Cancer Screening
0%53 patients1/55-star benchmark: 98%
Colorectal Cancer Screening
2%177 patients1/55-star benchmark: 88%
Controlling High Blood Pressure
63%60 patients3/55-star benchmark: 91%
Dementia: Cognitive Assessment
73%73 patients
Diabetes: Eye Exam
0%96 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
46%96 patients3/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
100%2,071 patients5/55-star benchmark: 100%
e-Prescribing
99%511 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
16%312 patients1/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
34%149 patients2/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
83%107 patients4/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 2% · 384 patients
2%384 patients
Provide Patients Electronic Access to Their Health Information
28%253 patients1/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
87%69 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 3% · 319 patients
Patients totalRate: 9% · 327 patients
7%327 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 14

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
10 suppliers19 claims52 services$6.64 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003
DME-Other DME · category DE000N
2 suppliers15 claims29 services$1.31 avg. paid by Medicare
Commode chair, mobile or stationary, with detachable arms E0165
DME-Other DME · category DE000N
1 supplier21 claims21 services$8.09 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
2 suppliers40 claims40 services$42.94 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers32 claims36 services$3.98 avg. paid by Medicare
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) E0630
DME-Other DME · category DE000N
3 suppliers37 claims37 services$41.58 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VANESSA ALICEA MATOS R.D.
Dietitian, Registered
2003 W FULTON ST, SUITE 105
CHICAGO, IL 60612
Cook County (312) 850-3438
SASHA JUNE R.D.
Dietitian, Registered
2003 W FULTON ST, STE 105
CHICAGO, IL 60612
Cook County (312) 850-3438
MICHAEL L FESSENDEN M.D.
Family Medicine
2003 W FULTON ST, 3RD FLOOR
CHICAGO, IL 60612
Cook County (773) 292-4800
ALISON MUSARACA RDN, LDN
Dietitian, Registered
2003 W FULTON ST
CHICAGO, IL 60612
Cook County (312) 850-3438
NICOLE M LEAHY PA-C
Physician Assistant
2003 W FULTON ST
CHICAGO, IL 60612
Cook County (312) 243-2223
DR. MARY ANN KAMINSKI PHARMD, BCACP
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2003 W FULTON ST, 402
CHICAGO, IL 60612
Cook County (312) 202-3500
CHARLOTTE GAMBLA
Dietitian, Registered
2003 W FULTON ST
CHICAGO, IL 60612
Cook County (312) 850-3438
MR. CARL V KNUTSEN R.PH.
Pharmacist
2003 W FULTON ST, SUITE 401
CHICAGO, IL 60612
Cook County (312) 222-8020

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theodise Harris's NPI number?

The NPI number for Theodise Harris is 1134716830. It was assigned to this individual provider in the NPPES registry on December 29, 2020.

Where is Theodise Harris located?

Theodise Harris practices at 2003 W Fulton St, Chicago, IL 60612. The listed phone number is (312) 243-2223.

What is Theodise Harris's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Theodise Harris enrolled in Medicare?

Yes. Theodise Harris is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Theodise Harris affiliated with any hospitals?

According to CMS data, Theodise Harris is affiliated with Northwest Community Hospital 1.

When was this NPI record last updated?

The NPPES record for Theodise Harris was last updated on March 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.