Ethan Michael Meisel, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

036.123753 Issued in IL

Practice address

211 E Ontario St
Suite 925
Chicago, IL 60611-3468

Phone

(312) 573-0614

Fax

(312) 573-0694

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Emergency Medicine

Education

Rush Medical College of Rush University, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Emory Medical Care Foundation IncGroup PAC ID 4981501814, 1,003 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079
• Emory University Hospital Midtown Hospital, Atlanta, GA, CCN 110078

Merit-based Incentive Payment System (MIPS)

Final score

93.24 of 100Reported as group

Quality

73.72

Promoting interoperability

100

Improvement activities

40

Cost

75.22

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: emeisel20060@direct.emory.org

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.

• Emory Medical Care Foundation Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1063452381

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment Care Compare group NPD
• Emory Medical Care Foundation Inc

  • Diagnostic Radiology Physician
  • Atlanta, GA
  • NPI 1225294739
  NPD
• Illinois Phlebology Associates SC

  • Surgery Physician
  • Orland Park, IL
  • NPI 1154378040
  NPD (past)
• Vein Clinics of Chicago LLC

  • Vascular Surgery Physician
  • Chicago, IL
  • NPI 1386904621
  NPD (past)
• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555
  NPD (past)
• Emory Health Care

  • Neurology Physician
  • Atlanta, GA
  • NPI 1376642751
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Crawford Long Hospital

  dba Emory University dba Emory Crawford Long Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1144203563
  Care Compare affiliation
• Grady Memorial Hospital Corporation

  dba Grady Health Systems

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1992799050
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1013029511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD",
            "address_2": "SUITE 300",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151050",
            "telephone_number": "630-725-2832",
            "fax_number": "877-489-5993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E ONTARIO ST",
            "address_2": "SUITE 925",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113468",
            "telephone_number": "312-573-0614",
            "fax_number": "312-573-0694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEISEL",
        "first_name": "ETHAN",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "H95343",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036.123753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171006162A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171006162B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD INDIVIDUAL PTAN",
            "identifier": "P01186845",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Meinen, PSY.D.
• Elizabeth Meinert
• Kristin Anne Meinke, AU.D.
• Michael Meinzer, PHD
• Caroline Meis
• Katherine Meisner, LMT
• Hannah Meissner, MD
• Joel Meister
• Madeline M Meister
• Alyssa Nicole Meixelsperger, LCSW, CADC

• General Practice Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.