Individual provider Active NPI

Joseph H Kent, MD

  • Infectious Disease Physician
  • Crestwood, IL
National Provider Identifier
1649266933
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
036-071273 Issued in IL
Practice address
13755 S. Cicero Ave
Crestwood, IL 60445
Phone
(888) 220-6432
Fax
(708) 385-7840
NPI assigned
Sep 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 036-071273 IL Primary

Addresses

Primary practice location

13755 S. Cicero Ave
Crestwood, IL 60445

Mailing address

901 McClintock Dr
Suite 202
Burr Ridge, IL 60527-0872
Phone (888) 220-6432

Other identifiers 2

IdentifierTypeStateIssuer
036-071-273MedicaidIL
0420315MedicaidIA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jkent253171@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 IL, WA2 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
I20041215000130 IL Practitioner - Infectious Disease 0143287789 Reassigns benefits to 1 organization
I20200429001180 WA Practitioner - Infectious Disease 0143287789

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Washington University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13755 Cicero Ave
Crestwood, IL 60418-1824
Phone (888) 220-6432

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-071273ILMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1649266933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 MCCLINTOCK DR",
            "address_2": "SUITE 202",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270872",
            "telephone_number": "888-220-6432",
            "fax_number": "630-654-4253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13755 S. CICERO AVE",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "60445",
            "telephone_number": "888-220-6432",
            "fax_number": "708-385-7840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENT",
        "first_name": "JOSEPH",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": "036-071273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-071-273",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0420315",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkent253171@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "13755 S. CICERO AVE",
            "city": "CRESTWOOD",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60445",
            "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": "13755 S. CICERO AVE",
            "city": "CRESTWOOD",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crestwood, IL

Sources for this page

Verify at the official NPI Registry.