Jeffrey Ryan Pua, M.D.

Primary specialty

Obesity Medicine (Internal Medicine) PhysicianTaxonomy code 207RB0002X

License

036-121475 Issued in IL

Practice address

801 N Cass Ave Ste 300
Westmont, IL 60559-1193

Phone

(630) 348-3840

Fax

(630) 364-4770

NPI assigned

May 17, 2008

Last updated

Aug 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

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

Specialty

Internal Medicine

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpua173309@dulyhealthandcare.direct-ci.com

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.

• Dupage Medical Group LTD

  dba DuPage Medical Group

  • Multi-Specialty Clinic/Center
  • Downers Grove, IL
  • NPI 1801833983
  Medicare reassignment Care Compare group NPD
• Edward Health Ventures

  • Multi-Specialty Clinic/Center
  • Bolingbrook, IL
  • NPI 1962452912
  Medicare reassignment NPD
• Laser Trim Corp

  dba Trim Body Sculpting

  • Obesity Medicine (Internal Medicine) Physician
  • Atlanta, GA
  • NPI 1861017899
  NPD Authorized official
• Dupage Medical Group LTD

  • Durable Medical Equipment & Medical Supplies
  • Glen Ellyn, IL
  • NPI 1760979447
  NPD
• Edward Health Ventures

  • Clinic/Center
  • Yorkville, IL
  • NPI 1952785909
  NPD

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

{
    "created_epoch": "1210982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1689831778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N CASS AVE STE 300",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591193",
            "telephone_number": "630-348-3840",
            "fax_number": "630-364-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUA",
        "first_name": "JEFFREY",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-17",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-121475",
            "primary": false
        },
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "IL",
            "license": "036-121475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036121475",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpua173309@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3011 Butterfield Rd Ste 240",
            "city": "Oak Brook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605233132",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpua173309@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "3011 Butterfield Rd Ste 240",
            "city": "Oak Brook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605233132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Prorehab PC (Athletico Physical Therapy)
• Provider Solutions Inc
• Holly Prowant, COTA/L
• Victoria Lyn Pruitt
• Jenna Karen Pryor, M.S., CF-SLP
• Sylvia Pudelko, DPT
• Macey Purdom, APN
• Cathryn A Puskarich, PH D
• Sara E Pustai, DNP
• Cory Puyear, PT

• Obesity Medicine (Internal Medicine) Physician in Westmont, IL
• Providers in Westmont, IL by specialty
• Obesity Medicine (Internal Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.