NPIMap

Individual provider Active NPI

Jaroslav Tymouch, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Chicago, IL
National Provider Identifier
1255561510
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
036116592 Issued in IL
Practice address
2515 W Chicago Ave
Chicago, IL 60622-4516
Phone
(773) 697-7946
Fax
(312) 864-9542
NPI assigned
Jul 21, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036-116592 IL
Pain Medicine (Anesthesiology) Physician 207LP2900X 036116592 IL Primary

Addresses

Primary practice location

2515 W Chicago Ave
Chicago, IL 60622-4516

Mailing address

619 N Campbell Ave
Chicago, IL 60612-1101
Phone (773) 398-3351

Other practice location 1

3000 Dundee Rd Ste 208
Northbrook, IL 60062-2432
Phone (847) 272-7727

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jtymouch@direct.ccprovider.org Direct Cook County

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
I20101223000190 IL Practitioner - AnesthesiologyPractitioner - Pain Management 0547458119 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Encore Anesthesia Group LLCGroup PAC ID 3476979683, 35 clinicians

Practice addresses (Care Compare)

2515 W Chicago Ave
Chicago, IL 60622-4516
Phone (773) 697-7946

701 W N Ave
Melrose Park, IL 60160-1612
Phone (708) 681-3200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
74.7
Promoting interoperability
100
Improvement activities
40
Cost
85.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-116592ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Illinois, LLC Anesthesiology CurrentSince Jun 1, 2016 Accepting new patients
Cook County Anesthesiology CurrentSince Nov 4, 2010 Accepting new patients
Cook County Current Accepting new patients
Cook County CurrentSince Nov 4, 2010 Accepting new patients
Painless Medical Practice LTD Pain Medicine CurrentSince Jul 15, 2010 Accepting new patients
North American Partners in Anesthesia (Illinois), LLC Anesthesiology CurrentSince Jan 27, 2018 Accepting new patients
Thorek Memorial Hospital PastSince Jul 15, 2010 Accepting new patients
John H Stroger Jr Hospital Cook County Past Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227

7435 W Talcott Ave
Chicago, IL 60631
Phone (773) 467-9977

2515 W Chicago Ave
Chicago, IL 60622
Phone (312) 583-1066

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

20201 Crawford Ave
Olympia Flds, IL 60461
Phone (708) 503-3857

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

Interoperability endpoints

  • Direct secure messaging: jtymouch@direct.ccprovider.org
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 9

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 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1255561510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 N CAMPBELL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121101",
            "telephone_number": "773-398-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224516",
            "telephone_number": "773-697-7946",
            "fax_number": "312-864-9542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Dundee Rd Ste 208",
            "address_purpose": "LOCATION",
            "city": "Northbrook",
            "state": "IL",
            "postal_code": "600622432",
            "country_code": "US",
            "telephone_number": "847-272-7727",
            "fax_number": "847-272-7673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYMOUCH",
        "first_name": "JAROSLAV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-21",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036-116592",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036116592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtymouch@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.