Individual provider Active NPI

Eric H Nippoldt, M.D.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1063948131
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036.150069 Issued in IL
Practice address
7435 W Talcott Ave
Resurrection Em Residency
Chicago, IL 60631-3707
Phone
(773) 792-7921
NPI assigned
May 10, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 01083518A IN
Emergency Medicine Physician 207P00000X 036.150069 IL Primary

Addresses

Primary practice location

7435 W Talcott Ave
Resurrection Em Residency
Chicago, IL 60631-3707

Mailing address

7435 W Talcott Ave
Resurrection Em Residency
Chicago, IL 60631-3707
Phone (773) 792-7921

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
I20190917001824 IL Practitioner - Emergency Medicine 7416228523 Reassigns benefits to 1 organization
I20200429001914 IN Practitioner - Emergency Medicine 7416228523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.150069ILMDEmergency Medicine Physician
01083518AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cepamerica Illinois LLP Emergency Medicine Current Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Dec 2, 2022 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Dec 2, 2022 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Feb 1, 2022 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Feb 1, 2022 Accepting new patients

Locations

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

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

1431 N Claremont Ave
Chicago, IL 60622
Phone (312) 491-5498

7435 W Talcott Ave
Chicago, IL 60631
Phone (773) 467-9977

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1494374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1063948131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7435 W TALCOTT AVE",
            "address_2": "RESURRECTION EM RESIDENCY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313707",
            "telephone_number": "773-792-7921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7435 W TALCOTT AVE",
            "address_2": "RESURRECTION EM RESIDENCY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313707",
            "telephone_number": "773-792-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIPPOLDT",
        "first_name": "ERIC",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-10",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01083518A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.150069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.