Individual provider Active NPI

Edwin M Hinton IV, D.O.

  • Emergency Medicine Physician
  • Chicago Heights, IL
National Provider Identifier
1609823855
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036-107350 Issued in IL
Practice address
1423 Chicago Rd
Chicago Heights, IL 60411-3400
Phone
(708) 756-1000
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036-107350 IL Primary

Addresses

Primary practice location

1423 Chicago Rd
Chicago Heights, IL 60411-3400

Mailing address

555 W Court St
Kankakee, IL 60901-3675
Phone (708) 479-6981

Other identifiers 1

IdentifierTypeStateIssuer
036107350MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040610001111 IL Practitioner - Emergency Medicine 0345149555 Reassigns benefits to 1 organization
I20171204002853 OK Practitioner - Emergency Medicine 0345149555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.51 of 100Reported as group
Quality
84.87
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6307OKMDClinical Social Worker
036-107350ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians of Cook County LLC Emergency Medicine CurrentSince Aug 1, 2017 Accepting new patients
Emergency Medicine Physicians of Tulsa County, LLC Emergency Medicine CurrentSince Nov 1, 2017 Accepting new patients
Owasso Medical Facility, Inc Past Accepting new patients
St John Sapulpa, Inc. Past Accepting new patients
Saint Francis Hospital South LLC Past Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients
St. John Broken Arrow, Inc Past Accepting new patients

Locations

20201 Crawford Ave
Olympia Flds, IL 60461
Phone (708) 503-3857

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

10501 E 91st St
Tulsa, OK 74133
Phone (918) 307-6000

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1609823855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W COURT ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013675",
            "telephone_number": "708-479-6981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 CHICAGO RD",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604113400",
            "telephone_number": "708-756-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINTON",
        "first_name": "EDWIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-107350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036107350",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Heights, IL

Sources for this page

Verify at the official NPI Registry.