NPIMap

Individual provider Active NPI

Pamela A Eernisse, DPM

  • Podiatrist
  • Justice, IL
National Provider Identifier
1427036151
Registry record updated Feb 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
16004918 Issued in IL
Practice address
9050 W 81St St
Justice, IL 60458-1350
Phone
(708) 594-3500
Fax
(708) 594-3524
NPI assigned
Jan 3, 2006
Last updated
Feb 14, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Podiatrist 213E00000X 16004918 IL Primary

Addresses

Primary practice location

9050 W 81St St
Justice, IL 60458-1350

Mailing address

PO Box 967
Tinley Park, IL 60477-0967
Phone (312) 337-2468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070720000881 IL Practitioner - Podiatry 2163523028 Reassigns benefits to 2 organizations
I20230105001420 MS Practitioner - Podiatry 2163523028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caplis Foot Center IncGroup PAC ID 2062825300, 2 clinicians

Practice addresses (Care Compare)

999 N Halstead Rd
Ocean Springs, MS 39564-3105
Phone (228) 818-2801

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue44
Removal of skin lesions12
Removal of nail tissue114
Removal or shaving of skin growth51
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16004918ILMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot Specialists of South Mississippi PLLC Podiatrist CurrentSince Nov 15, 2022 Accepting new patients
Pam Eernisse DPM SC Podiatrist CurrentSince Nov 2, 2002 Accepting new patients
Caplis Foot Center, Inc. Podiatrist CurrentSince Nov 15, 2022 Accepting new patients
Pam Eernisse DPM SC Durable Medical Equipment & Medical Supplies CurrentSince Nov 2, 2002 Accepting new patients
Michigan Ave Podiatry LLC 1 CurrentSince Aug 1, 2015 Accepting new patients
Camilleri Medical Center LTD Podiatrist PastSince Jan 1, 1999 Accepting new patients
Pam Eernisse DPM SC Past Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

30 N Michigan Ave
Ste 720
Chicago, IL 60602
Phone (312) 701-0770

9050 W 81st St
Oak Lawn, IL 60458
Phone (708) 563-0330

999 N Halstead Rd
Ocean Springs, MS 39564
Phone (228) 818-2801

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

Hospital & facility affiliations 61

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202947200000",
    "number": "1427036151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 967",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604770967",
            "telephone_number": "312-337-2468",
            "fax_number": "312-337-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9050 W 81ST ST",
            "city": "JUSTICE",
            "state": "IL",
            "postal_code": "604581350",
            "telephone_number": "708-594-3500",
            "fax_number": "708-594-3524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EERNISSE",
        "first_name": "PAMELA",
        "middle_name": "A",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-03",
        "last_updated": "2008-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "16004918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Justice, IL

Sources for this page

Verify at the official NPI Registry.