Individual provider Active NPI

Fred Anthony Lepore Jr.

  • Emergency Medicine Physician
  • Dyer, IN
National Provider Identifier
1013151463
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
02004195A Issued in IN
Practice address
24 Joliet St
Dyer, IN 46311-1705
Phone
(708) 895-9385
NPI assigned
Apr 29, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036128619 IL
Emergency Medicine Physician 207P00000X 02004195A IN Primary

Addresses

Primary practice location

24 Joliet St
Dyer, IN 46311-1705

Mailing address

4750 Hempstead Station Dr
Kettering, OH 45429-5164
Phone (800) 875-0136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120911000604 IL Practitioner - Emergency Medicine 7810145117 Reassigns benefits to 1 organization
I20131009001883 IN Practitioner - Emergency Medicine 7810145117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians
Clarksville Emergency Group PCGroup PAC ID 6507277423, 149 clinicians

Practice addresses (Care Compare)

20201 Crawford Ave
Olympia Fields, IL 60461-1010
Phone (708) 747-4000

701 Superior Ave
Munster, IN 46321-4037
Phone (219) 922-4200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.41 of 100Reported as group
Quality
86.81
Improvement activities
40
Cost
77.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02004195AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine Current Accepting new patients
Clarksville Emergency Group, PC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Cep America - Illinois, LLP Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

20201 Crawford Ave
Olympia Flds, IL 60461
Phone (708) 503-3857

1141 Hospital Dr NW
Corydon, IN 47112
Phone (812) 738-7830

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

701 Superior Ave
Munster, IN 46321
Phone (219) 922-4200

Interoperability endpoints

  • Direct secure messaging: flepore67879@direct.franciscanalliance.org

Organizations & group practices 4

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 1

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": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1013151463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 HEMPSTEAD STATION DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295164",
            "telephone_number": "800-875-0136",
            "fax_number": "937-619-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 JOLIET ST",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111705",
            "telephone_number": "708-895-9385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEPORE",
        "first_name": "FRED",
        "middle_name": "ANTHONY",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-29",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036128619",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02004195A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyer, IN

Sources for this page

Verify at the official NPI Registry.