Individual provider Active NPI

Taratip Thupvong, M.D.

  • Anesthesiology Physician
  • Aurora, IL
National Provider Identifier
1457500993
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036121440 Issued in IL
Practice address
2000 Ogden Ave
Aurora, IL 60504-7222
Phone
(630) 978-6200
NPI assigned
Sep 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036121440 IL Primary

Addresses

Primary practice location

2000 Ogden Ave
Aurora, IL 60504-7222

Mailing address

426 Scarborough Rd
Valparaiso, IN 46385-7718
Phone (219) 462-2594

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tthupvong226699@direct.luhs.org Direct

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
I20081113000169 IL Practitioner - Anesthesiology 6204995798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catalyst Anesthesia Group LLCGroup PAC ID 1658525753, 6 clinicians

Practice addresses (Care Compare)

850 W Irving Park Rd
Chicago, IL 60613-3077
Phone (773) 525-6780

Hospital & facility affiliations

  • Thorek Memorial Hospital Hospital, Chicago, IL, CCN 140115

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036121440ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catalyst Anesthesia Group, LLC Anesthesiology CurrentSince Nov 15, 2012 Accepting new patients

Locations

26413 Network Pl
Chicago, IL 60673

3 Erie Ct
Oak Park, IL 60302
Phone (708) 763-6200

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1457500993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 SCARBOROUGH RD",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463857718",
            "telephone_number": "219-462-2594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 OGDEN AVE",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047222",
            "telephone_number": "630-978-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THUPVONG",
        "first_name": "TARATIP",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-09",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036121440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tthupvong226699@direct.luhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2000 Ogden Ave",
            "city": "Aurora",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605047222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.