NPIMap

Individual provider Active NPI

David P Beckmann, MD

  • Family Medicine Physician
  • Evergreen Park, IL
National Provider Identifier
1407015704
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036130007 Issued in IL
Practice address
9730 S Western Ave Ste 700
Evergreen Park, IL 60805-2814
Phone
(708) 572-7575
Fax
(708) 572-7576
NPI assigned
Jun 3, 2008
Last updated
Dec 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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 036130007 IL Primary

Addresses

Primary practice location

9730 S Western Ave Ste 700
Evergreen Park, IL 60805-2814

Mailing address

10260 191St St Ste 100
Mokena, IL 60448-8802
Phone (708) 572-7575

Other practice location 1

10260 191st St Ste 100
Mokena, IL 60448-8802
Phone (708) 572-7575

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address whc@providea.gwaydirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121022000180 IL Practitioner - Family Practice 6103097118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Chicago, Pritzker School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providea Health Partners LLCGroup PAC ID 5698904878, 7 clinicians

Practice addresses (Care Compare)

10260 191St St
Suite 100
Mokena, IL 60448-8802
Phone (708) 572-7606

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
99.2
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
A Lota Healthcare LTD Family Medicine CurrentSince Jan 26, 2022 Accepting new patients
Providea Health Partners, LLC Family Medicine CurrentSince Oct 1, 2019 Accepting new patients
Dean Health Systems, Inc Family Medicine Past Accepting new patients

Locations

9730 S Western Ave
Ste 700
Evergreen Pk, IL 60805
Phone (708) 425-1907

10260 191st St
Ste 100
Mokena, IL 60448
Phone (708) 425-1907

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.70301

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

Hospital & facility affiliations 11

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": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1407015704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10260 191ST ST STE 100",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488802",
            "telephone_number": "708-572-7575",
            "fax_number": "708-572-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 S WESTERN AVE STE 700",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052814",
            "telephone_number": "708-572-7575",
            "fax_number": "708-572-7576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10260 191st St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Mokena",
            "state": "IL",
            "postal_code": "604488802",
            "country_code": "US",
            "telephone_number": "708-572-7575",
            "fax_number": "708-572-7576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BECKMANN",
        "first_name": "DAVID",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-03",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036130007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "whc@providea.gwaydirect.com",
            "affiliation": "N",
            "endpointDescription": "EHR direct mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct mail",
            "address_1": "10260 191st St Ste 100",
            "city": "Mokena",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604488802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.