Individual provider Active NPI

Nicklas Robert Pfanzelter, MD

  • Medical Oncology Physician
  • Glenview, IL
National Provider Identifier
1598968976
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
036133170 Issued in IL
Practice address
2180 Pfingsten Rd.
Kellogg Cancer Center
Glenview, IL 60026
Phone
(847) 503-1000
Fax
(847) 503-1100
NPI assigned
Jun 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 036133170 IL Primary

Addresses

Primary practice location

2180 Pfingsten Rd.
Kellogg Cancer Center
Glenview, IL 60026

Mailing address

2180 Pfingsten Rd.
Kellogg Cancer Center
Glenview, IL 60026-1339
Phone (847) 503-1000

Other practice location 1

2180 Pfingsten Rd
Glenview, IL 60026-1339
Phone (847) 503-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address npfanzelter269483@direct.northshore.org

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131017001992 IL Practitioner - Medical OncologyPractitioner - Internal MedicinePractitioner - Hematology/Oncology 1850525296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
University of Chicago, Pritzker School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2100 Pfingsten Rd
Glenview, IL 60026-1301

2180 Pfingsten Rd
Glenview, IL 60026-1339

2650 Ridge Ave
Evanston, IL 60201-1700

757 Park Ave W
Highland Park, IL 60035-2558

777 Park Ave W
Highland Park, IL 60035-2433

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Internal Medicine Current Accepting new patients
Endeavor Health Medical Group CurrentSince Sep 4, 2018 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2180 Pfingsten Rd
Glenview, IL 60026
Phone (847) 503-1000

757 Park Ave W
Highland Park, IL 60035
Phone (847) 480-3800

Interoperability endpoints

  • Direct secure messaging: npfanzelter269483@direct.northshore.org

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1598968976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 PFINGSTEN RD.",
            "address_2": "KELLOGG CANCER CENTER",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261339",
            "telephone_number": "847-503-1000",
            "fax_number": "847-503-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 PFINGSTEN RD.",
            "address_2": "KELLOGG CANCER CENTER",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "60026",
            "telephone_number": "847-503-1000",
            "fax_number": "847-503-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2180 Pfingsten Rd",
            "address_purpose": "LOCATION",
            "city": "Glenview",
            "state": "IL",
            "postal_code": "600261339",
            "country_code": "US",
            "telephone_number": "847-503-1000",
            "fax_number": "847-503-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PFANZELTER",
        "first_name": "NICKLAS",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "IL",
            "license": "036133170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "npfanzelter269483@direct.northshore.org",
            "affiliation": "N",
            "address_1": "2180 Pfingsten Rd.",
            "address_2": "Kellogg Cancer Center",
            "city": "Glenview",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

Verify at the official NPI Registry.