Individual provider Active NPI

Eric Dean Lopatin, MD

  • Family Medicine Physician
  • Troy, IL
National Provider Identifier
1356381271
Registry record updated Feb 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036075388 Issued in IL
Practice address
301 Edwardsville Road
Troy, IL 62294
Phone
(618) 667-7057
Fax
(618) 667-8131
NPI assigned
Jun 8, 2006
Last updated
Feb 11, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036075388 IL Primary

Addresses

Primary practice location

301 Edwardsville Road
Troy, IL 62294

Mailing address

301 Edwardsville Road
Troy, IL 62294
Phone (618) 667-7057

Other identifiers 1

IdentifierTypeStateIssuer
036075388MedicaidIL

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
I20051229000562 IL Practitioner - Family Practice 5597787838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Columbia School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anderson Medical Group LLCGroup PAC ID 5193792018, 136 clinicians

Practice addresses (Care Compare)

301 Edwardsville Rd
Troy, IL 62294-1303
Phone (618) 667-7057

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.76 of 100Reported as group
Quality
54.98
Promoting interoperability
85
Improvement activities
40
Cost
73.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036075388ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Medical Group, LLC Family Medicine CurrentSince Dec 1, 2022 Accepting new patients

Locations

6810 State Route 162
Ste 215
Maryville, IL 62062
Phone (618) 391-6405

301 Edwardsville Rd
Troy, IL 62294
Phone (618) 667-7057

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265846400000",
    "number": "1356381271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 EDWARDSVILLE ROAD",
            "city": "TROY",
            "state": "IL",
            "postal_code": "62294",
            "telephone_number": "618-667-7057",
            "fax_number": "618-667-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 EDWARDSVILLE ROAD",
            "city": "TROY",
            "state": "IL",
            "postal_code": "62294",
            "telephone_number": "618-667-7057",
            "fax_number": "618-667-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPATIN",
        "first_name": "ERIC",
        "middle_name": "DEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036075388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036075388",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, IL

Sources for this page

Verify at the official NPI Registry.