Active NPI
Jay Lawrence Koyner, M.D.
- Nephrology Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- Practice address
- 5841 S Maryland Ave
Suite S-506, MC 5100
Chicago, IL 60637-1447 - Phone
- (773) 702-4842
- Fax
- (773) 702-5818
- NPI assigned
- Apr 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | IL | Primary |
Addresses
Primary practice location
5841 S Maryland Ave
Suite S-506, MC 5100
Chicago, IL 60637-1447
Mailing address
5841 S Maryland Ave
Suite S-506, MC 5100
Chicago, IL 60637-1447
Phone (773) 702-4842
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- State University of New York at Stony Brook, School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (773) 702-1000
Hospital & facility affiliations
- The University of Chicago Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-110329 | IL | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The University of Chicago Medical Center | Current | Accepting new patients | |
| University of Chicago | Current | Accepting new patients | |
| The University of Chicago Medical Center | Current | Accepting new patients |
Locations
150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061
Interoperability endpoints
- jkoynermd22838@uchospital.direct-ci.com
Organizations & group practices 3
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.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1033218128
-
- Multi-Specialty Clinic/Center
- Chicago, IL
- NPI 1821048786
-
- Community/Retail Pharmacy
- Calumet City, IL
- NPI 1255895678
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1508956509
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275656340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5841 S MARYLAND AVE",
"address_2": "SUITE S-506, MC 5100",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606371447",
"telephone_number": "773-702-4842",
"fax_number": "773-702-5818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5841 S MARYLAND AVE",
"address_2": "SUITE S-506, MC 5100",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606371447",
"telephone_number": "773-702-4842",
"fax_number": "773-702-5818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOYNER",
"first_name": "JAY",
"middle_name": "LAWRENCE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.