Individual provider Active NPI

Catherine Lee Eden, M.D.

  • Urology Physician
  • Maywood, IL
National Provider Identifier
1215226865
Registry record updated Dec 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
125060343 Issued in IL
Practice address
2160 S 1St Ave
Loyola University Medical Center C/O General Surgery
Maywood, IL 60153-3328
Phone
(708) 216-6901
Fax
(708) 216-4796
NPI assigned
Apr 5, 2011
Last updated
Dec 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Urology Physician 208800000X 125060343 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Loyola University Medical Center C/O General Surgery
Maywood, IL 60153-3328

Mailing address

2160 South 1St Ave
C/O Urology Department
Maywood, IL 60153
Phone (708) 216-5100

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
I20170711001824 IL Practitioner - Urology 8628379419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Georgetown University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rockford Urological Associates LTDGroup PAC ID 3971604380, 13 clinicians

Practice addresses (Care Compare)

351 Executive Pkwy
Rockford, IL 61107-5339
Phone (815) 398-4057

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125060343ILMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Urological Associates, LTD. Urology CurrentSince Aug 21, 2017 Accepting new patients

Locations

351 Executive Pkwy
Rockford, IL 61107
Phone (815) 398-4057

351 Executive Pkwy
Ste M4
Rockford, IL 61107
Phone (815) 398-4057

Interoperability endpoints

  • Direct secure messaging: catherineeden@rua.medalliesdirect.net
  • FHIR API: https://app.meldrx.com/api/fhir/uc30108_rockforduroassoc

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450224000000",
    "number": "1215226865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 SOUTH 1ST AVE",
            "address_2": "C/O UROLOGY DEPARTMENT",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "LOYOLA UNIVERSITY MEDICAL CENTER C/O GENERAL SURGERY",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-6901",
            "fax_number": "708-216-4796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDEN",
        "first_name": "CATHERINE",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2015-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "125060343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.