NPIMap

Individual provider Active NPI

George E Tzelepis, MD

  • Pulmonary Disease Physician
  • Maryville, IL
National Provider Identifier
1497769558
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
036078975 Issued in IL
Practice address
6810 State Route 162 Ste 202
Maryville, IL 62062-8566
Phone
(618) 288-6844
Fax
(618) 288-6852
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 036078975 IL Primary

Addresses

Primary practice location

6810 State Route 162 Ste 202
Maryville, IL 62062-8566

Mailing address

6810 State Route 162
Box 215
Maryville, IL 62062
Phone (618) 391-6495

Other practice location 1

25 N Harlem Ave
Freeport, IL 61032-3801
Phone (815) 599-7140

Other practice location 2

101 E Miller Rd
Sterling, IL 61081-1252
Phone (815) 625-4790

Other identifiers 1

IdentifierTypeStateIssuer
036078975MedicaidIL

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
I20110210000290 IL Practitioner - Pulmonary Disease 9436156924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
74.76 of 100Reported as group
Quality
54.98
Promoting interoperability
85
Improvement activities
40
Cost
73.39

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CGH Medical Center Current Accepting new patients
CGH Medical Center CurrentSince Oct 8, 2019 Accepting new patients
CGH Medical Center CurrentSince Oct 8, 2019 Accepting new patients
Decatur Memorial Hospital CurrentSince Jan 18, 2022 Accepting new patients
Decatur Memorial Hospital Pulmonary Disease CurrentSince Jan 18, 2022 Accepting new patients
Sunrise Medical Group, LLC Pulmonary Disease Past Accepting new patients
Ajit P Kuruvilla MD LLC Pulmonary Disease Past Accepting new patients
Freeport Memorial Hospital PastSince Jun 16, 2024 Accepting new patients
Emma L. Bixby Medical Center Past Accepting new patients
Gaithersburg Critical Care Associates LLC Pulmonary Disease Past Accepting new patients
Bixby Hospital Past Accepting new patients

Locations

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

241 W Weaver Rd
Ste 145B
Forsyth, IL 62535
Phone (217) 876-5220

101 E Miller Rd
Sterling, IL 61081
Phone (815) 632-5285

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1497769558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 STATE ROUTE 162",
            "address_2": "BOX 215",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "62062",
            "telephone_number": "618-391-6495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6810 STATE ROUTE 162 STE 202",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628566",
            "telephone_number": "618-288-6844",
            "fax_number": "618-288-6852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 N Harlem Ave",
            "address_purpose": "LOCATION",
            "city": "Freeport",
            "state": "IL",
            "postal_code": "610323801",
            "country_code": "US",
            "telephone_number": "815-599-7140",
            "fax_number": "815-599-7113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 E Miller Rd",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "IL",
            "postal_code": "610811252",
            "country_code": "US",
            "telephone_number": "815-625-4790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TZELEPIS",
        "first_name": "GEORGE",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036078975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036078975",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

Verify at the official NPI Registry.