Individual provider Active NPI

Scott Feldman, MD

  • Psychiatry Physician
  • Evanston, IL
National Provider Identifier
1407940166
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036095587 Issued in IL
Practice address
820 Davis St
Suite # 450
Evanston, IL 60201-4431
Phone
(847) 328-2404
Fax
(847) 328-1295
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036095587 IL Primary

Addresses

Primary practice location

820 Davis St
Suite # 450
Evanston, IL 60201-4431

Mailing address

1565 Maple Ave
Suite 105
Evanston, IL 60201-4371
Phone (847) 246-4783

Other identifiers 2

IdentifierTypeStateIssuer
036095587MedicaidIL
1619067OtherILBCBS GROUP NUMBER

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
I20120508000422 IL Practitioner - Psychiatry 8426210444 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036095587ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Sep 3, 2021 Accepting new patients
University of Chicago CurrentSince Sep 3, 2021 Accepting new patients
The University of Chicago Medical Center CurrentSince Sep 3, 2021 Accepting new patients
Andrea M. Bacon, M.D. LTD. Psychiatry Past Accepting new patients
Tapestry 360 Health Past Accepting new patients
Behavioral Health and Education Specialists Inc Psychiatry PastSince Jul 1, 2010 Accepting new patients
Bhes Medical Group, LLC Past Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

4840 N Marine Dr
Chicago, IL 60640
Phone (773) 878-9700

6501 S Promontory Dr
Chicago, IL 60649
Phone (773) 256-5724

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

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Interoperability endpoints

  • Direct secure messaging: scott.feldman.1@11074.direct.athenahealth.com
  • Direct secure messaging: sfeldman221963@uchospital.direct-ci.com
  • Direct secure messaging: scott.feldman.1@27315.direct.athenahealth.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1407940166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 MAPLE AVE",
            "address_2": "SUITE 105",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014371",
            "telephone_number": "847-246-4783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 DAVIS ST",
            "address_2": "SUITE # 450",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014431",
            "telephone_number": "847-328-2404",
            "fax_number": "847-328-1295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDMAN",
        "first_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036095587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036095587",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "1619067",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.