Tatyana Kagan, M.D.

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

036-102378 Issued in IL

Practice address

9933 Lawler Ave
Skokie, IL 60077-3703

Phone

(847) 626-0303

Fax

(847) 626-0191

NPI assigned

Dec 5, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EGHCBA/Endpoint/EGHCBA

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.

• Cook County

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1588612832
  Medicare reassignment NPD
• North Shore Pediatrics

  • Legal Medicine
  • Skokie, IL
  • NPI 1467737882
  NPD (past) Authorized official
• Cook County

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1821385170

  Pediatrics

  NPD
• Cook County

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1831219450
  NPD

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1508924267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9933 LAWLER AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773703",
            "telephone_number": "847-626-0303",
            "fax_number": "847-626-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9933 LAWLER AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773703",
            "telephone_number": "847-626-0303",
            "fax_number": "847-626-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAGAN",
        "first_name": "TATYANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "IL",
            "license": "036102378",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-102378",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "IL",
            "license": "036-102378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "542161791",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkaganp@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• K Medical Group LLC
• Paul John Kachoris, MD
• Allan N Kaczala, PH.D.
• Gregory D Kaczmarek, MD
• William Joel Kafin, MD
• Elena G Kaiser, MAAT ATR LCPC
• Daniel Kaitis, MD
• Arthur Kalinski
• Lucie Kalm
• Jacqueline Ann Kalmoe, M.D.

• Pediatric Emergency Medicine (Pediatrics) Physician in Skokie, IL
• Providers in Skokie, IL by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.