Active NPI
Paul Eapen, MD
- Surgery Physician
- Chicago, IL
National Provider Identifier
1114548922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 125080857
- Practice address
- 620 S Paulina St
Suite 403
Chicago, IL 60612 - Phone
- (312) 942-5000
- NPI assigned
- May 4, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 125080857 | IL | Primary |
Addresses
Primary practice location
620 S Paulina St
Suite 403
Chicago, IL 60612
Mailing address
620 S Paulina St
Suite 403
Chicago, IL 60612
Phone (312) 942-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260624004236 | IN | Practitioner - Anesthesiology | 2062892383 |
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- University of Louisville School of Medicine, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
8558 Broadway
Merrillville, IN 46410-7032
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125080857 | IL | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657238400000",
"number": "1114548922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 S PAULINA ST",
"address_2": "SUITE 403",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60612",
"telephone_number": "312-942-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 S PAULINA ST",
"address_2": "SUITE 403",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60612",
"telephone_number": "312-942-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EAPEN",
"first_name": "PAUL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-04",
"last_updated": "2022-07-08",
"certification_date": "2022-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "125080857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.