Betsy Malicakal Eapen, D.O.
Individual provider Active NPI Nephrology Physician · Streamwood, IL
NPI 1497913651 · NPPES record last updated Aug 24, 2015
Key facts
- NPI
- 1497913651
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- 036-125071 (IL)
- Practice address
- 1243 Tuscany Dr
Streamwood, IL 60107-4531 - Phone
- (917) 348-4769
- Fax
- (224) 238-7780
- NPI assigned
- May 23, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 25
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- New York College of Osteo Medicine of New York Institute of Technology, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Emergency Medicine Associates P.a., P.C.
Mdics at Civista LLC
Shore-Bayy Hospitalists Associates
Practice addresses (Care Compare)
100 Brown St
Chestertown, MD 21620-1435
Phone (410) 778-3300
24440 Stone Springs Blvd
Dulles, VA 20166-2247
Phone (240) 686-2300
5 Garrett Ave
La Plata, MD 20646-5960
Phone (443) 949-0814
5255 Loughboro Rd NW
Washington, DC 20016-2633
Phone (301) 623-4352
7651 Woodland Dr
Easton, MD 21601-8141
Phone (410) 310-6245
Hospital & facility affiliations
- University of MD Charles Regional Medical Center
- University of MD Shore Medical Center at Easton
- University of Maryland Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in GA, MD, DC, VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111207000577 | GA | Practitioner - Internal Medicine | 0345396453 | Reassigns benefits to 1 organization |
| I20130325000469 | MD | Practitioner - Internal Medicine |
0345396453 | Reassigns benefits to 9 organizations |
| I20141113000830 | DC | Practitioner - Internal Medicine |
0345396453 | Reassigns benefits to 5 organizations |
| I20150302001964 | VA | Practitioner - Internal Medicine | 0345396453 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-125071 | IL | MD | Nephrology Physician |
Practice roles
Locations (25 of 36)
5255 Loughboro Rd NW
Washington, DC 20016
Phone (202) 243-2280
3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203
1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401
1200 Northside Forsyth Dr
Cumming, GA 30041
Phone (770) 292-4806
1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000
1700 Medical Way
Snellville, GA 30078
Phone (770) 978-4229
2000 W Baltimore St
Baltimore, MD 21223
Phone (410) 362-3075
827 Linden Ave
Baltimore, MD 21201
Phone (410) 225-8100
100 Brown St
Chestertown, MD 21620
Phone (410) 778-3300
7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000
12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255
219 S Washington St
Easton, MD 21601
106 Bow St
Elkton, MD 21921
Phone (410) 298-2000
400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300
1406 Crain Hwy S
Ste 106
Glen Burnie, MD 21061
Phone (410) 768-6440
11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600
3001 Hospital Dr
Hyattsville, MD 20785
Phone (301) 618-2000
701 Charles St
La Plata, MD 20646
Phone (301) 609-4000
5 Garrett Ave
La Plata, MD 20646
Phone (301) 609-4000
18101 Prince Philip Dr
Olney, MD 20832
Phone (301) 774-8618
100 Hospital Rd
Prnc Frederck, MD 20678
Phone (410) 414-4791
1235 Potomac Valley Rd
Rockville, MD 20850
Phone (301) 299-2273
9000 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 682-7000
1500 Forest Glen Rd
Silver Spring, MD 20910
Phone (301) 754-7230
200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000
Interoperability endpoints
- beapen547965@direct.umm.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 036-125071 | IL | Yes |
| Nephrology Physician | 207RN0300X | 065357 | GA |
Addresses
Primary practice location
1243 Tuscany Dr
Streamwood, IL 60107-4531
Mailing address
1243 Tuscany Dr
Streamwood, IL 60107-4531
Phone (917) 348-4769
Other providers in Streamwood, IL
- Brandon Tien DO
- Doan Counseling LLC
- Nicole Doan
- Nina Ivanova Dobreva
- Emilia Ann Durkin
- Christine Eble
- Ecker Center for Behavioral Health
- Ecker Center for Behavioral Health
- Hazel Enriquez
- Eric W Bohl DDS LTD
All providers in Streamwood, IL · Nephrology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.