Individual provider Active NPI

Charles Raymond Caffrey, M.D.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1104243138
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
125065324 Issued in IL
Practice address
211 E Ontario St
Chicago, IL 60611-3468
Phone
(312) 694-7000
NPI assigned
Mar 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2018003021 MO
Emergency Medicine Physician 207P00000X 125065324 IL Primary

Addresses

Primary practice location

211 E Ontario St
Chicago, IL 60611-3468

Mailing address

211 E Ontario St
Chicago, IL 60611-3468
Phone (312) 694-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20180711001643 MO Practitioner - Emergency Medicine 5496050338 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospitals East CommunitiesGroup PAC ID 1658276811, 92 clinicians

Practice addresses (Care Compare)

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (636) 251-6000

Hospital & facility affiliations

  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018003021MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospitals East Communities Emergency Medicine CurrentSince Jul 9, 2018 Accepting new patients
Mercy Hospital South Emergency Medicine CurrentSince Aug 25, 2019 Accepting new patients
Mercy Hospital Jefferson CurrentSince Aug 25, 2019 Accepting new patients
Mercy Hospital Jefferson CurrentSince Aug 25, 2019 Accepting new patients
Cep America, LLC Emergency Medicine Current Accepting new patients
Mercy Hospitals East Communities CurrentSince Jul 1, 2019 Accepting new patients
Mercy Hospital South CurrentSince Aug 25, 2019 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jul 9, 2018 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Dec 5, 2019 Accepting new patients
Mercy Hospitals East Communities Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Mercy Hospital Lincoln CurrentSince Mar 18, 2019 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Dec 5, 2019 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

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

12303 De Paul Dr
Bridgeton, MO 63044
Phone (314) 344-6360

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

1000 E Cherry St
Troy, MO 63379
Phone (636) 528-3327

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

Organizations & group practices 13

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.

View all 13

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": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1104243138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E ONTARIO ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113468",
            "telephone_number": "312-694-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E ONTARIO ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113468",
            "telephone_number": "312-694-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAFFREY",
        "first_name": "CHARLES",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-27",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2018003021",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125065324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.