Nathan Ackerman
Individual provider Active NPI Otolaryngology Physician · Champaign, IL
NPI 1306208640 · NPPES record last updated Jan 5, 2022
Key facts
- NPI
- 1306208640
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Otolaryngology Physician 207Y00000X
- License
- 036157298 (IL)
- Practice address
- 3101 Fields South Dr
Champaign, IL 61822-3743 - Phone
- (217) 366-1243
- NPI assigned
- Mar 25, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Otolaryngology
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Christie Clinic, PLLC
Practice addresses (Care Compare)
3101 Fields S Dr
Champaign, IL 61822-3743
Phone (217) 366-4000
Hospital & facility affiliations
- Carle Foundation Hospital
- Osf Heart of Mary Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211004002630 | IL | Practitioner - Otolaryngology | 3476951591 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036157298 | IL | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christie Clinic, PLLC | Current |
Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
3101 Fields South Dr
Champaign, IL 61822
Phone (217) 366-1237
101 W University Ave
Champaign, IL 61820
Phone (217) 366-1255
1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684
Interoperability endpoints
- nackermanmd333148@carlehiedirect.net
- nathan.ackerman.1@14258.direct.athenahealth.com
- nackerman414694@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 036157298 | IL | Yes |
Addresses
Primary practice location
3101 Fields South Dr
Champaign, IL 61822-3743
Mailing address
101 W University Ave
Champaign, IL 61820-3981
Phone (217) 366-1243
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nackermanmd333148@CarleHieDirect.net | Direct |
Other providers in Champaign, IL
- Jason Abrams
- Nadia Abuamouneh
- Abusua Doula Services
- Accelerated Rehabilitation Centers
- Accent Counseling LLC
- Elizabeth A Ackerson
- Dule Acuna
- Courtney Adair
- Alanna Adams
- Maria Adams
All providers in Champaign, IL · Otolaryngology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.