Active NPI
Thomas Carberry, M.D.
- Pediatric Cardiology Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Cardiology Physician
- License
- 4301506609
- Practice address
- 225 E Chicago Ave # 21
Chicago, IL 60611 - Phone
- (312) 227-5329
- NPI assigned
- Jan 21, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Cardiology Physician | 2080P0202X | 4301506609 | MI | Primary |
Addresses
Primary practice location
225 E Chicago Ave # 21
Chicago, IL 60611
Mailing address
225 E Chicago Ave # 21
Chicago, IL 60611-2991
Phone (312) 227-5329
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Michigan Ave NE
Grand Rapids, MI 49503-2560
100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115
4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301506609 | MI | MD | Pediatric Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeland Hospitals at Niles and St Joseph, Inc | Current | Accepting new patients | |
| Spectrum Health Primary Care Partners | Current | Accepting new patients | |
| Spectrum Health Hospitals | Current | Accepting new patients | |
| Lakeland Hospitals at Niles and St Joseph, Inc | Current | Accepting new patients | |
| Spectrum Health Primary Care Partners | Pediatric Cardiology | Current | Accepting new patients |
| Spectrum Health Hospitals | Pediatric Cardiology | Current | Accepting new patients |
Locations
225 E Chicago Ave
#21
Chicago, IL 60611
Phone (312) 227-2200
100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680
25 Michigan St NE
Ste 4200
Grand Rapids, MI 49503
Phone (616) 267-9150
100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242
588 E Lakewood Blvd
Fl 1
Holland, MI 49424
Phone (616) 494-5800
4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600
2009 Holton Rd
North Muskegon, MI 49445
Phone (231) 291-8020
225 N State St
Reed City, MI 49677
Phone (231) 832-7108
1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941
3950 Hollywood Rd
Ste 240
Saint Joseph, MI 49085
Phone (269) 408-1852
1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000
Interoperability endpoints
- tcarberry483058@epic00.corewelldirect.org
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1235188673
Pediatric Cardiology
-
- General Acute Care Hospital
- Saint Joseph, MI
- NPI 1134220031
-
- Hospitalist Physician
- Grand Rapids, MI
- NPI 1558407189
Pediatric Cardiology
-
- Community Health Clinic/Center
- Saint Joseph, MI
- NPI 1184513731
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1922090554
-
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1689499667
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656028800000",
"number": "1487043907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 E CHICAGO AVE # 21",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112991",
"telephone_number": "312-227-5329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 E CHICAGO AVE # 21",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60611",
"telephone_number": "312-227-5329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARBERRY",
"first_name": "THOMAS",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-01-21",
"last_updated": "2022-06-24",
"certification_date": "2022-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "MI",
"license": "4301506609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.