CMS-1500 Box 24J / 33a • NPI
1073490314
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
163WW0000X
Licensed & Credentialed Registered Nurse, Wound Care
Box 32 Service Location & ZIP+4
2118 N HALSTED ST, CHICAGO, IL, 60614-0758
✓ 9-Digit EDI 837 ZIP+4 (60614-0758)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1073490314 (1977 MESK MEDICAL GROUP LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1073490314 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | 1977 MESK MEDICAL GROUP LLC |
| Plain-English Specialty | Licensed & Credentialed Registered Nurse, Wound Care NUCC Code: 163WW0000X (Registered Nurse, Wound Care) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 2118 N HALSTED ST, CHICAGO, IL, 60614-0758 |
| Practice Telephone / Fax | Tel: (407) 305-3791 |
| Administrative Mailing Address | 2118 N HALSTED ST, CHICAGO, IL, 60614-0758 |
| Enumeration & Last Sync | Enumerated: 2025-08-19 | CMS Record Updated: 2026-01-26 |
| Authorized Official | RALPH UGARTE (Manager) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (163WW0000X)
What Does Taxonomy Code 163WW0000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 163WW0000X translates to:
"Licensed & Credentialed Registered Nurse, Wound Care"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (1977 MESK MEDICAL GROUP LLC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207Q00000X — Family MedicinePlain English: Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) | State: N/A | License: Verified | Primary: Secondary |
163WW0000X — Registered Nurse, Wound CarePlain English: Licensed & Credentialed Registered Nurse, Wound Care | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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