Individual provider Active NPI

Elisa A Hofmann, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Geneva, IL
National Provider Identifier
1043217490
Registry record updated Oct 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036089617 Issued in IL
Practice address
302 Randall Rd
Geneva, IL 60134-4205
Phone
(630) 208-6775
Fax
(630) 208-7937
NPI assigned
Jun 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036089617 IL Primary

Addresses

Primary practice location

302 Randall Rd
Geneva, IL 60134-4205

Mailing address

302 Randall Rd
Geneva, IL 60134-4205
Phone (630) 208-6775

Other identifiers 5

IdentifierTypeStateIssuer
P01209463OtherILMEDICARE RAILROAD (PROVIDER PTAN)
206147OtherILMEDICARE PTAN (GROUP)
036089617MedicaidIL
206147115OtherILMEDICARE PTAN (INDIVIDUAL)
CA4748OtherILMEDICARE RAILROAD (GROUP PTAN)

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
I20120815000798 IL Practitioner - Endocrinology 4082634910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Loyola University of Chicago, Stritch School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

233 S Gary Ave
Bloomingdale, IL 60108-2213
Phone (630) 208-6775

300 Randall Rd
Geneva, IL 60134-4200
Phone (630) 933-4700

304 Randall Rd
Geneva, IL 60134-4200
Phone (630) 307-7799

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036089617ILMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince May 31, 2012 Accepting new patients
Central Dupage Physician Group Endocrinology, Diabetes & Metabolism CurrentSince May 31, 2012 Accepting new patients
Fox Valley Endocrinology, LLC Endocrinology, Diabetes & Metabolism PastSince May 1, 2002 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

302 Randall Rd
Geneva, IL 60134
Phone (630) 208-6775

302 Randall Rd
Ste 304
Geneva, IL 60134
Phone (630) 208-6775

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

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 3

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": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382486400000",
    "number": "1043217490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 RANDALL RD",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344205",
            "telephone_number": "630-208-6775",
            "fax_number": "630-208-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 RANDALL RD",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344205",
            "telephone_number": "630-208-6775",
            "fax_number": "630-208-7937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFMANN",
        "first_name": "ELISA",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2013-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036089617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD (PROVIDER PTAN)",
            "identifier": "P01209463",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (GROUP)",
            "identifier": "206147",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036089617",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "206147115",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD (GROUP PTAN)",
            "identifier": "CA4748",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

Verify at the official NPI Registry.