Kevin Patrick Cavanaugh, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036140256 Issued in IL

Practice address

755 N Wells, Suite 201
Chicago, IL 60654

Phone

(312) 280-6747

NPI assigned

Jul 30, 2010

Last updated

Jan 2, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

DermatologyAlso: Internal Medicine

Education

University of Minnesota Medical School, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Center for Dermatology and Aesthetic Medicine LLCGroup PAC ID 3678860087, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rush University Medical Center Hospital, Chicago, IL, CCN 140119

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Center for Dermatology and Aesthetic Medicine, LLC

  • Dermatology Physician
  • Chicago, IL
  • NPI 1447601414
  Medicare reassignment Care Compare group NPD
• Rush University Medical Group

  dba Rush University Internists

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542

  Dermatology

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Rush University Medical Center

  • Children's Hospital
  • Chicago, IL
  • NPI 1801908728
  Care Compare affiliation
• Rush University Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1932213600
  Care Compare affiliation

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

{
    "created_epoch": "1280448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514851200000",
    "number": "1184938284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 N WELLS, SUITE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60654",
            "telephone_number": "312-280-6747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 N WELLS, SUITE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60654",
            "telephone_number": "312-280-6747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "KEVIN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-30",
        "last_updated": "2018-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036140256",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.057829",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Cavallo, PSYD
• Robert W Cavanagh, PH.D
• Erin Brigh Cavanaugh, M.D.
• James L Cavanaugh Jr., MD
• Katherine Cavanaugh, AG-ACNP
• Mary Patricia Cavanaugh, M.D.
• Nicholas Cavanaugh, DO
• Amy Louise Cavazos, MAAT, LCPC
• SJ Cave Doi, MPH
• Mary A Cavender, DN

• Dermatology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2018; 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.

Verify at the official NPI Registry.