Michael D Coulson, D.O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

036.077834 Issued in IL

Practice address

1 Kish Hospital Drive
Dekalb, IL 60115-9602

Phone

(815) 756-1521

Fax

(815) 748-8395

NPI assigned

Jun 30, 2005

Last updated

Jul 14, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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

AnesthesiologyAlso: Pain Management

Education

Ohio Medical University, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Associates, LTDGroup PAC ID 2961303425, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Presence Mercy Medical Center Hospital, Aurora, IL, CCN 140174
• Northwestern Medicine Kishwaukee Hospital Hospital, Dekalb, IL, CCN 140286

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, 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.

• Anesthesia Associates, LTD

  • Pain Medicine (Anesthesiology) Physician
  • Aurora, IL
  • NPI 1952308223
  Medicare reassignment Care Compare group NPD Authorized official
• Valley Pain Care Centers LTD

  • Pain Medicine Physician
  • Dekalb, IL
  • NPI 1194722058
  Medicare reassignment NPD Authorized official

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

• Kishwaukee Community Hospital

  dba Northwestern Medicine Kishwaukee Hospital

  • General Acute Care Hospital
  • Dekalb, IL
  • NPI 1669534517
  Care Compare affiliation
• Mercy Medical Center - Aurora LLC

  • General Acute Care Hospital
  • Aurora, IL
  • NPI 1598503922
  Care Compare affiliation

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1255338554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KISH HOSPITAL DRIVE",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159602",
            "telephone_number": "815-756-1521",
            "fax_number": "815-748-8395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KISH HOSPITAL DRIVE",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159602",
            "telephone_number": "815-756-1521",
            "fax_number": "815-748-8395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULSON",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036077834",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036.077834",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "336.040926",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Dekalb, IL
• Providers in Dekalb, IL by specialty
• Anesthesiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; 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.