NPIMap

Individual provider Active NPI

Tiffany Eileen Groen, D.O.

  • Family Medicine Physician
  • New Lenox, IL
National Provider Identifier
1609019538
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036133259 Issued in IL
Practice address
1900 Silver Cross Blvd Ste 120
New Lenox, IL 60451-9509
Phone
(815) 469-8806
NPI assigned
Apr 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036133259 IL Primary

Addresses

Primary practice location

1900 Silver Cross Blvd Ste 120
New Lenox, IL 60451-9509

Mailing address

1900 Silver Cross Blvd Ste 120
New Lenox, IL 60451-9509
Phone (815) 469-8806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130819000813 IL Practitioner - Family PracticePractitioner - Preventive Medicine 6608018718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Preventive Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Service Systems, IncGroup PAC ID 2264408699, 63 clinicians

Practice addresses (Care Compare)

1890 Silver Cross Blvd
Suite 265
New Lenox, IL 60451-9623
Phone (815) 727-4292

1900 Silver Cross Blvd
New Lenox, IL 60451-9509

Hospital & facility affiliations

  • Silver Cross Home Health Home health agency, New Lenox, IL, CCN 147452
  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Ingalls Memorial Hospital Hospital, Harvey, IL, CCN 140191
  • Advocate Trinity Hospital Hospital, Chicago, IL, CCN 140048
  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Health Service Systems, Inc CurrentSince Mar 2, 2020 Accepting new patients
Health Service Systems, Inc Family Medicine CurrentSince Mar 2, 2020 Accepting new patients
Advocate Health and Hospitals Corporation Past Accepting new patients

Locations

1890 Silver Cross Blvd
Ste 265
New Lenox, IL 60451
Phone (815) 727-4292

1851 Silver Cross Blvd
Ste 120
New Lenox, IL 60451

1900 Silver Cross Blvd
Ste 120
New Lenox, IL 60451
Phone (815) 469-8806

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1239148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1609019538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER CROSS BLVD STE 120",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519509",
            "telephone_number": "815-469-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SILVER CROSS BLVD STE 120",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519509",
            "telephone_number": "815-469-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROEN",
        "first_name": "TIFFANY",
        "middle_name": "EILEEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-08",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036133259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

Verify at the official NPI Registry.