Individual provider Active NPI

Thomas Bump, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Evergreen Park, IL
National Provider Identifier
1013941053
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
036-062686 Issued in IL
Practice address
3545 W 95TH St
Evergreen Park, IL 60805-2135
Phone
(708) 346-5562
Fax
(708) 346-2059
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036-062686 IL
Clinical Cardiac Electrophysiology Physician 207RC0001X 036-062686 IL Primary

Addresses

Primary practice location

3545 W 95TH St
Evergreen Park, IL 60805-2135

Mailing address

3545 W 95TH St
Evergreen Park, IL 60805-2135
Phone (708) 346-5562

Other practice location 1

4400 W 95th St
Suite 306
Oak Lawn, IL 60453-2654
Phone (708) 346-5562 ext. 23

Other practice location 2

5151 W 95th St
Oak Lawn, IL 60453-6460
Phone (708) 346-5562

Other identifiers 9

IdentifierTypeStateIssuer
036062686MedicaidIL
1619991361OtherILGROUP NPI#
IL4014007OtherILMEDICARE PTAN#
1477731685OtherILGROUP NPI#
685583OtherGROUP MEDICARE#
IL4013007OtherILMEDICARE PTAN#
P00713296/CK6882OtherILMEDICARE RAILROAD
203979007OtherILMEDICARE PTAN-SPI
0001619074OtherBROUP BC/BS#

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tombump@direct.practicefusion.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20040623000184 IL Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 2567447501 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Harvard Medical School, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Consultants in Cardiology and Electrophysiololgy LLCGroup PAC ID 4880779727, 21 clinicians

Practice addresses (Care Compare)

3545 W 95TH St
Evergreen Park, IL 60805-2135
Phone (708) 346-5562

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-062686ILMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heart Care Centers of Illinois, SC Cardiovascular Disease CurrentSince Apr 1, 2013 Accepting new patients
High Technology, Inc. PastSince Sep 1, 2006 Accepting new patients

Locations

3231 Euclid Ave
Ste 400
Berwyn, IL 60402
Phone (708) 478-3600

2338 New St
Blue Island, IL 60406
Phone (708) 577-5060

2800 W 95th St
Evergreen Pk, IL 60805
Phone (708) 229-5104

500 N Wall St
Kankakee, IL 60901
Phone (815) 937-9300

4400 W 95th St
Ste 306
Oak Lawn, IL 60453
Phone (708) 684-5428

5454 Hohman Ave
Hammond, IN 46320
Phone (219) 933-2077

Networks

  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806

Interoperability endpoints

  • Direct secure messaging: tombump@direct.practicefusion.com
  • Direct secure messaging: tbump277434@direct.myadvocateaurora.org

Organizations & group practices 3

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 4

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1013941053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052135",
            "telephone_number": "708-346-5562",
            "fax_number": "708-346-2059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052135",
            "telephone_number": "708-346-5562",
            "fax_number": "708-346-2059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4400 W 95th St",
            "address_2": "Suite 306",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604532654",
            "country_code": "US",
            "telephone_number": "708-346-5562 x23",
            "fax_number": "708-346-2059",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5151 W 95th St",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604536460",
            "country_code": "US",
            "telephone_number": "708-346-5562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUMP",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036-062686",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "IL",
            "license": "036-062686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036062686",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI#",
            "identifier": "1619991361",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN#",
            "identifier": "IL4014007",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI#",
            "identifier": "1477731685",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE#",
            "identifier": "685583",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN#",
            "identifier": "IL4013007",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00713296/CK6882",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN-SPI",
            "identifier": "203979007",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BROUP BC/BS#",
            "identifier": "0001619074",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tombump@direct.practicefusion.com",
            "affiliation": "N",
            "address_1": "3545 W 95th St",
            "city": "Evergreen Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "608052135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.