Jeffrey L Floyd, PA-C
Individual provider Active NPI Physician Assistant · Harvey, IL
NPI 1366775447 · NPPES record last updated Nov 22, 2021
Key facts
- NPI
- 1366775447
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 085003562 (IL)
- Practice address
- 31 W 155TH St
Harvey, IL 60426-3556 - Phone
- (708) 596-5177
- Fax
- (708) 596-5518
- NPI assigned
- Sep 8, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Integrated Health Solutions SC
Genesis Integrative Medicine LLC
Practice addresses (Care Compare)
10751 165TH St
Suite 100
Orland Park, IL 60467-8702
Phone (708) 403-5075
1881 S Randall Rd
Suite C
Geneva, IL 60134-2532
Phone (630) 845-8925
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: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091110000591 | IL | Practitioner - Physician Assistant | 1850439944 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085003562 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Physical Medicine & Therapy, LTD. | Past |
Accepting new patients | |
| Hari Om Namo SC | Past | Accepting new patients | |
| Home and Wound Care Physicians PC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085003562 | IL | Yes |
Addresses
Primary practice location
31 W 155TH St
Harvey, IL 60426-3556
Mailing address
31 W 155TH St
Harvey, IL 60426-3556
Phone (708) 596-5177
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 085003562 | Medicaid | IL |
Other providers in Harvey, IL
- Family Guidance Centers, Inc.
- Family Guidance Centers, Inc.
- Field Surgical Associates LTD.
- Timothy P Flood
- Elbio M. Flores
- Goldwyn Bonner Foggie
- Lateisha Nicole Fort
- Jerrlene Foster-Strong
- Larry L Foster
- Al J Fraiser
All providers in Harvey, IL · Physician Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2021. 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.