NPIMap

Individual provider Active NPI

James F Koop, M.D.

  • Internal Medicine Physician
  • Melrose Park, IL
National Provider Identifier
1255420451
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036086979 Issued in IL
Practice address
675 W North Ave
Suite 409
Melrose Park, IL 60160-1634
Phone
(708) 450-5070
Fax
(708) 450-5078
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036086979 IL Primary

Addresses

Primary practice location

675 W North Ave
Suite 409
Melrose Park, IL 60160-1634

Mailing address

675 W North Ave
Suite #409
Melrose Park, IL 60160-1634
Phone (708) 450-5070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081029000564 IL Practitioner - Internal Medicine 6305904780 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elio M Vento MD and Associates SCGroup PAC ID 4284688748, 8 clinicians

Practice addresses (Care Compare)

2350 Royal Blvd
Suite 100
Elgin, IL 60123-4718
Phone (847) 695-8100

675 W N Ave
Suite 409
Melrose Park, IL 60160-1624
Phone (708) 450-5070

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036086979ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
James Koop MD LLC Internal Medicine CurrentSince Jun 5, 2002 Accepting new patients
Gottlieb Community Health Services Corporation Past Accepting new patients
Cardinalight Health, LLC PastSince Oct 7, 2008 Accepting new patients

Locations

675 W North Ave
Ste 409
Melrose Park, IL 60160
Phone (708) 450-5070

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21874/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/FDBJBA/Endpoint/FDBJBA

Organizations & group practices 4

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 10

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301443200000",
    "number": "1255420451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE",
            "address_2": "SUITE #409",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601634",
            "telephone_number": "708-450-5070",
            "fax_number": "708-450-5078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE",
            "address_2": "SUITE 409",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601634",
            "telephone_number": "708-450-5070",
            "fax_number": "708-450-5078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOP",
        "first_name": "JAMES",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036086979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

Verify at the official NPI Registry.