Jeanene Marie Caccopola, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036109750 Issued in IL

Practice address

550 Fox Glen CT
Barrington, IL 60010-1833

Phone

(847) 868-0484

Fax

(847) 305-1456

NPI assigned

Oct 18, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 13, 2016 through Jun 13, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jcaccopola237885@direct.myadvocateaurora.org

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.

• Heightened Health SC

  • Family Medicine Physician
  • Barrington, IL
  • NPI 1700379450
  NPD Authorized official

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1093704439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 FOX GLEN CT",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600101833",
            "telephone_number": "847-868-0484",
            "fax_number": "847-305-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 FOX GLEN CT",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600101833",
            "telephone_number": "847-868-0484",
            "fax_number": "847-305-1456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "290 N Rand Rd",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Lake Zurich",
            "state": "IL",
            "postal_code": "600472213",
            "country_code": "US",
            "telephone_number": "847-438-4028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CACCOPOLA",
        "first_name": "JEANENE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036109750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Barrington, IL
• Providers in Barrington, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.