Individual provider Active NPI

Cyril N Philip, MD

  • Interventional Pain Medicine Physician
  • Lake Geneva, WI
National Provider Identifier
1578713343
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
55669 Issued in WI
Practice address
850 Geneva Parkway N
Ste 100
Lake Geneva, WI 53147-4562
Phone
(262) 299-6199
Fax
(262) 293-6953
NPI assigned
Sep 29, 2008
Last updated
Nov 30, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 55669 WI
Interventional Pain Medicine Physician 208VP0014X 55669 WI Primary

Addresses

Primary practice location

850 Geneva Parkway N
Ste 100
Lake Geneva, WI 53147-4562

Mailing address

850 Geneva Parkway N
Ste 100
Lake Geneva, WI 53147-4562
Phone (262) 299-6199

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cphilip42433@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20110722000574 WI Practitioner - Interventional Pain ManagementPractitioner - AnesthesiologyPractitioner - Pain Management 7416071618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain Management
Education
Loyola University of Chicago, Stritch School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advantage Physical Therapy and Sports Rehab, LLCGroup PAC ID 8022016336, shared by 3 NPIs, 289 clinicians

Practice addresses (Care Compare)

10222 74TH St
Kenosha, WI 53142-6810
Phone (262) 925-5020

204 S Pine St
Burlington, WI 53105-1914
Phone (419) 221-6717

3620 57TH Ave
Kenosha, WI 53144-4925
Phone (262) 925-5250

5024 Green Bay Rd
Kenosha, WI 53144-1702
Phone (419) 221-6717

7200 Washington Ave
Mount Pleasant, WI 53406-6516
Phone (262) 583-0790

850 Geneva Pkwy N
Suite 100
Lake Geneva, WI 53147-4562
Phone (262) 299-6199

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55669WIMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Sports and Interventional Spine SC Interventional Pain Medicine CurrentSince May 18, 2020 Accepting new patients
Midwest Sports and Interventional Spine SC Pain Medicine CurrentSince Apr 2, 2021 Accepting new patients
Spine and Neuro Health and Wellness Center LLC CurrentSince Jan 13, 2021 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

1954 1st St
Ste 163
Highland Park, IL 60035

2070 Green Bay Rd
Highland Park, IL 60035
Phone (773) 575-5740

4824 Green Bay Rd
Kenosha, WI 53144
Phone (262) 299-6199

800 Geneva Pkwy N
Ste 102
Lake Geneva, WI 53147
Phone (262) 248-4105

850 Geneva Pkwy N
Lake Geneva, WI 53147
Phone (262) 299-6199

850 Geneva Pkwy N
Ste 100
Lake Geneva, WI 53147
Phone (262) 299-6199

Interoperability endpoints

  • Direct secure messaging: cphilip42433@direct.myadvocateaurora.org
  • Direct secure messaging: cyril.philip@3895.securemail.prognocis.com
  • Direct secure messaging: cyril.philip@4028.securemail.prognocis.com

Organizations & group practices 5

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": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1578713343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 GENEVA PARKWAY N",
            "address_2": "STE 100",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531474562",
            "telephone_number": "262-299-6199",
            "fax_number": "262-293-6953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 GENEVA PARKWAY N",
            "address_2": "STE 100",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531474562",
            "telephone_number": "262-299-6199",
            "fax_number": "262-293-6953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIP",
        "first_name": "CYRIL",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-29",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "WI",
            "license": "55669",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "WI",
            "license": "55669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cphilip42433@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "850 GENEVA PARKWAY N",
            "address_2": "STE 100",
            "city": "Lake Geneva",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531474562",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "850 GENEVA PARKWAY N",
            "address_2": "STE 100",
            "city": "Lake Geneva",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531474562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake Geneva, WI

Sources for this page

Verify at the official NPI Registry.