Individual provider Active NPI

Thomas John Cockayne Jr., DPM

  • Podiatrist
  • Chicago, IL
National Provider Identifier
1063820231
Registry record updated Jul 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
135.000836 Issued in IL
Practice address
California Avenue at 15TH Street
Chicago, IL 60608
Phone
(773) 542-2000
NPI assigned
Jul 31, 2014
Last updated
Jul 31, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 135.000836 IL Primary

Addresses

Primary practice location

California Avenue at 15TH Street
Chicago, IL 60608

Mailing address

3001 Green Bay Rd
Podiatry
North Chicago, IL 60064-3048
Phone (847) 688-1900

Other names 1

  • Tom Cockayne Other name

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170626002396 IL Practitioner - Podiatry 6305115890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prairie Podiatry LLCGroup PAC ID 9436275369, 3 clinicians

Practice addresses (Care Compare)

2070 W Iles Ave
Springfield, IL 62704-4174
Phone (217) 698-6228

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
70.52 of 100Reported as individual
Quality
45.84
Promoting interoperability
82
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue148
Removal of skin lesions29
Removal of nail tissue1262
Removal or shaving of skin growth440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
135.000836ILMDPodiatrist

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AHABDD/Endpoint/AHABDD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406764800000",
    "number": "1063820231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 GREEN BAY RD",
            "address_2": "PODIATRY",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643048",
            "telephone_number": "847-688-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALIFORNIA AVENUE AT 15TH STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60608",
            "telephone_number": "773-542-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCKAYNE",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "135.000836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TOM",
            "last_name": "COCKAYNE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.