Individual provider Active NPI

Patrick Owen McCaffrey, M.D.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1336503226
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
125.069476 Issued in IL
Practice address
808 S Wood St
M/C 724
Chicago, IL 60612-7300
Phone
(312) 413-7492
NPI assigned
Apr 7, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X 125.069476 IL Primary

Addresses

Primary practice location

808 S Wood St
M/C 724
Chicago, IL 60612-7300

Mailing address

808 S Wood St
M/C 724
Chicago, IL 60612-7300
Phone (312) 413-7492

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191023001795 IL Practitioner - Emergency Medicine 5799071064 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.069476ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community First Healthcare of Illinois, Inc. Single Specialty CurrentSince Aug 17, 2019 Accepting new patients
Community First Healthcare of Illinois, Inc. Single Specialty CurrentSince Aug 17, 2019 Accepting new patients

Locations

5645 W Addison St
Chicago, IL 60634
Phone (773) 282-7000

5645 W Addison St
Ste 301
Chicago, IL 60634
Phone (773) 736-4553

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1336503226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 S WOOD ST",
            "address_2": "M/C 724",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127300",
            "telephone_number": "312-413-7492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 S WOOD ST",
            "address_2": "M/C 724",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127300",
            "telephone_number": "312-413-7492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAFFREY",
        "first_name": "PATRICK",
        "middle_name": "OWEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-07",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125.069476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.