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JOHANA B GIMENEZRODRIGUEZ MD
NPI 1417478629
Pediatrics in Chicago, IL

Active since June 28, 2017PECOS Enrolled
1276 N CLYBOURN AVE, CHICAGO, IL 60610(312) 337-1073(312) 337-7616 Get Directions Write a Review

NPPES record last updated: May 8, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 8, 2024, May 3, 2024, May 14, 2020 and 1 more (4 updates tracked since 2017).

About Johana B Gimenezrodriguez Md NPPES

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

JOHANA B GIMENEZRODRIGUEZ MD (NPI 1417478629) is an individual pediatrics provider in Chicago, Illinois, licensed in Illinois (036.152253) and active in the NPI registry since June 2017. She is enrolled in Medicare PECOS and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1417478629
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameJOHANA B GIMENEZRODRIGUEZCredential: MD
Location Address1276 N CLYBOURN AVEChicago, IL 60610-2003
Mailing Address1276 N Clybourn AveChicago, IL 60610-2003 · (312) 337-1073 · Fax (312) 337-7616
Phone(312) 337-1073
Fax(312) 337-7616
Sole ProprietorNo
Enumeration DateJune 28, 2017
Last NPPES UpdateMay 8, 20244 updates tracked since enumeration
NPPES CertifiedMay 8, 2024
✔ NPI 1417478629 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in IL · 036.152253
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1276 N CLYBOURN AVE, Chicago, IL 60610
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Other Names 1

Other Name (5)Johana B Gimenez Md

Secondary Practice Locations 3

Location 14116 N Lincoln AveChicago, IL 60618-3028 · Phone (773) 883-2350
Location 215 Founders Ln Ste 100Jacksonville, IL 62650-3924 · Phone (217) 243-0300 · Fax (217) 245-6775
Location 34500 Parsons BlvdFlushing, NY 11355-2205 · Phone (718) 670-5535

Other Identifiers 1

Other036.152253IL · Md License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Johana B Gimenezrodriguez Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Johana Gimenezrodriguez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Near North Health Service Corporation
Same address
Federally Qualified Health Center (FQHC)
1276 N CLYBOURN AVE
Chicago, IL 60610
  • Reassigned Medicare billing, Illinois enrollment
  • 45 clinicians in this Medicare group
NPI 1821079088 (312) 337-1073

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60610 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.

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.

ANDREW KOCH FNP
Nurse Practitioner (Family)
1276 N CLYBOURN AVE
CHICAGO, IL 60610
Cook County (312) 337-1073
NEAR NORTH HEALTH SERVICE CORPORATION
Public Health or Welfare
1276 N CLYBOURN AVE
CHICAGO, IL 60610
Cook County (331) 643-5238
LEELA JAIN MD
Pediatrics
1276 N CLYBOURN AVE
CHICAGO, IL 60610
Cook County (312) 337-1073
CHRISTINA SMITH LCSW
Social Worker (Clinical)
1276 N CLYBOURN AVE
CHICAGO, IL 60610
Cook County (312) 337-1073
MS. SYDNEY M JUNION DNP, AGNP-C
Nurse Practitioner
1276 N CLYBOURN AVE
CHICAGO, IL 60610
Cook County (312) 337-1073
JAKESHA ROGERS
Social Worker
1276 N CLYBOURN AVE
CHICAGO, IL 60610
Cook County (312) 337-1073
MRS. SARAH KEHINDE NKWOCHA APN
Nurse Practitioner (Family)
1276 N CLYBOURN AVE
CHICAGO, IL 60610
Cook County (312) 337-1073
DR. ROBERT SCOTT WALLER PSYD
Psychologist (Clinical)
1276 N CLYBOURN AVE
CHICAGO, IL 60610
Cook County (312) 337-1073

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 Johana Gimenezrodriguez's NPI number?

The NPI number for Johana Gimenezrodriguez is 1417478629. It was assigned to this individual provider in the NPPES registry on June 28, 2017. The provider is also known as Johana B Gimenez MD.

Where is Johana Gimenezrodriguez located?

Johana Gimenezrodriguez practices at 1276 N Clybourn Ave, Chicago, IL 60610. The listed phone number is (312) 337-1073.

What is Johana Gimenezrodriguez's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Johana Gimenezrodriguez enrolled in Medicare?

Yes. Johana Gimenezrodriguez is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Johana Gimenezrodriguez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Johana Gimenezrodriguez reassigns Medicare benefits to Near North Health Service Corporation (Chicago, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Johana Gimenezrodriguez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Johana Gimenezrodriguez accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Johana Gimenezrodriguez as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Johana Gimenezrodriguez was last updated on May 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.