Individual provider Active NPI

Tarun Jain, MD

  • Interventional Cardiology Physician
  • Kankakee, IL
National Provider Identifier
1316289077
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
036152003 Issued in IL
Practice address
500 N Wall St Ste C100
Kankakee, IL 60901-2942
Phone
(844) 404-4787
Fax
(815) 936-3243
NPI assigned
Mar 20, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036152003 IL
Interventional Cardiology Physician 207RI0011X 036152003 IL Primary

Addresses

Primary practice location

500 N Wall St Ste C100
Kankakee, IL 60901-2942

Mailing address

500 N Wall St Ste C100
Kankakee, IL 60901-2942
Phone (844) 404-4787

Other practice location 1

1490 E Walnut St Ste A
Watseka, IL 60970-1833
Phone (815) 432-7693

Other practice location 2

23120 S LaGrange Rd
Frankfort, IL 60423-7760
Phone (815) 464-5440

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tjain31262@Direct.riversidehealthcare.net Direct

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200801000020 IL Practitioner - Interventional Cardiology 8527290105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Health SystemGroup PAC ID 3274434717, 202 clinicians

Practice addresses (Care Compare)

500 N Wall St
Suite 100
Kankakee, IL 60901-2942
Phone (815) 933-2557

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting46
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036152003ILMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Health System CurrentSince Aug 7, 2020 Accepting new patients
Riverside Health System Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

300 Riverside Dr
Ste 2100
Bourbonnais, IL 60914
Phone (815) 928-9666

5775 E State Route 113
Coal City, IL 60416
Phone (815) 634-0100

23120 S Lagrange Rd
Frankfort, IL 60423
Phone (815) 464-5440

500 N Wall St
Ste C100
Kankakee, IL 60901
Phone (844) 404-4787

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

500 N Wall St
Ste 100
Kankakee, IL 60901
Phone (815) 933-2557

1490 E Walnut St
Ste A
Watseka, IL 60970
Phone (815) 432-7693

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

Interoperability endpoints

  • Direct secure messaging: tjain31262@direct.riversidehealthcare.net

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.

Hospital & facility affiliations 2

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": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1316289077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N WALL ST STE C100",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012942",
            "telephone_number": "844-404-4787",
            "fax_number": "815-936-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N WALL ST STE C100",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012942",
            "telephone_number": "844-404-4787",
            "fax_number": "815-936-3243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1490 E Walnut St Ste A",
            "address_purpose": "LOCATION",
            "city": "Watseka",
            "state": "IL",
            "postal_code": "609701833",
            "country_code": "US",
            "telephone_number": "815-432-7693",
            "fax_number": "815-936-7228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23120 S LaGrange Rd",
            "address_purpose": "LOCATION",
            "city": "Frankfort",
            "state": "IL",
            "postal_code": "604237760",
            "country_code": "US",
            "telephone_number": "815-464-5440",
            "fax_number": "815-936-5404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAIN",
        "first_name": "TARUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-20",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036152003",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036152003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tjain31262@Direct.riversidehealthcare.net",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 N Wall St Ste C100",
            "city": "Kankakee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609012942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kankakee, IL

Sources for this page

Verify at the official NPI Registry.