Individual provider Active NPI

Jarrod Siek Georgacakis, APN

  • Nurse Practitioner
  • Evanston, IL
National Provider Identifier
1215535638
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209021457 Issued in IL
Practice address
2650 Ridge Ave
Dept. of Anesthesiology
Evanston, IL 60201-1057
Phone
(847) 570-2760
NPI assigned
Oct 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209021457 IL Primary

Addresses

Primary practice location

2650 Ridge Ave
Dept. of Anesthesiology
Evanston, IL 60201-1057

Mailing address

2650 Ridge Ave
Dept. of Anesthesiology
Evanston, IL 60201-1057
Phone (847) 570-2760

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jgeorgacakis299977@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210127002864 IL Practitioner - Nurse Practitioner 9335553619 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Loyola University of Chicago, Stritch School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

4440 W 95TH St
Oak Lawn, IL 60453-2600

Hospital & facility affiliations

  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Current Accepting new patients
Endeavor Health Medical Group CurrentSince Nov 1, 2021 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Oct 1, 2020 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Oct 1, 2020 Accepting new patients
Endeavor Health Clinical Operations Past Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

9532 Eagle Way
Chicago, IL 60678

29373 Network Pl
Chicago, IL 60673

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520

4440 W 95th St
Ste 183
Oak Lawn, IL 60453
Phone (708) 684-3643

Interoperability endpoints

  • Direct secure messaging: jgeorgacakis299977@direct.myadvocateaurora.org

Organizations & group practices 5

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 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": "1602806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1215535638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "DEPT. OF ANESTHESIOLOGY",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011057",
            "telephone_number": "847-570-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "DEPT. OF ANESTHESIOLOGY",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011057",
            "telephone_number": "847-570-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGACAKIS",
        "first_name": "JARROD",
        "middle_name": "SIEK",
        "name_prefix": "Mr.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-16",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209021457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgeorgacakis299977@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4440 W 95th St",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2",
            "affiliation": "N",
            "address_1": "4440 W 95th St",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.