Individual provider Active NPI

Steven Decker, D.O.

  • Emergency Medicine Physician
  • Kankakee, IL
National Provider Identifier
1093754129
Registry record updated Jan 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036-088679 Issued in IL
Practice address
350 N Wall St
Kankakee, IL 60901-2901
Phone
(815) 933-1671
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036-088679 IL Primary

Addresses

Primary practice location

350 N Wall St
Kankakee, IL 60901-2901

Mailing address

2000 Green Rd
Suite 300
Ann Arbor, MI 48105-1598
Phone (734) 995-3764

Other identifiers 1

IdentifierTypeStateIssuer
036088679-7MedicaidIL

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
I20100728001162 IL Practitioner - Emergency Medicine 0941273866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Emergency Physicians LLCGroup PAC ID 6204294119, 35 clinicians

Practice addresses (Care Compare)

350 N Wall St
Kankakee, IL 60901-2901
Phone (815) 933-1671

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.25 of 100Reported as group
Quality
72.26
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-088679ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Emergency Physicians, LLC Emergency Medicine CurrentSince Jun 1, 2023 Accepting new patients
Epmg of Indiana, PC Past Accepting new patients

Locations

5665 New Northside Dr
Ste 320
Sandy Springs, GA 30328
Phone (770) 874-5468

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

Organizations & group practices 2

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 1

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296086400000",
    "number": "1093754129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 GREEN RD",
            "address_2": "SUITE 300",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051598",
            "telephone_number": "734-995-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N WALL ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012901",
            "telephone_number": "815-933-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKER",
        "first_name": "STEVEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2011-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-088679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088679-7",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kankakee, IL

Sources for this page

Verify at the official NPI Registry.