Individual provider Active NPI

Thomas J Rostafinski, PHD

  • Clinical Psychologist
  • River Forest, IL
National Provider Identifier
1508859521
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
713164 Issued in IL
Practice address
7627 Lake St Ste 215
River Forest, IL 60305-1878
Phone
(708) 848-1611
Fax
(708) 848-1436
NPI assigned
Aug 24, 2005
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 713164 IL Primary

Addresses

Primary practice location

7627 Lake St Ste 215
River Forest, IL 60305-1878

Mailing address

7627 Lake St Ste 215
River Forest, IL 60305-1878
Phone (708) 848-1611

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address trostafinski6805@direct.luhs.org Other LOYOLA UNIVERSITY MEDICAL CENTER

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050818000597 IL Practitioner - Clinical Psychologist 4284664202 Reassigns benefits to 2 organizations
Practice locations: Oak Park, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

7617 N Ave
River Forest, IL 60305-1133
Phone (708) 771-1300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
713164ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Mar 22, 2023 Accepting new patients
Loyola University Medical Center CurrentSince Mar 22, 2023 Accepting new patients
Davken Associates, P.C. Clinical CurrentSince Sep 23, 2016 Accepting new patients

Locations

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

7005 North Ave
Oak Park, IL 60302
Phone (708) 327-1410

7617 North Ave
River Forest, IL 60305
Phone (708) 771-1300

Organizations & group practices 3

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 2

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1508859521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7627 LAKE ST STE 215",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051878",
            "telephone_number": "708-848-1611",
            "fax_number": "708-848-1436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7627 LAKE ST STE 215",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051878",
            "telephone_number": "708-848-1611",
            "fax_number": "708-848-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSTAFINSKI",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "713164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "trostafinski6805@direct.luhs.org",
            "affiliation": "Y",
            "affiliationName": "LOYOLA UNIVERSITY MEDICAL CENTER",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR IPA",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in River Forest, IL

Sources for this page

Verify at the official NPI Registry.