Individual provider Active NPI

Theodore Morrison Homa, MD

  • Internal Medicine Physician
  • Arlington Heights, IL
National Provider Identifier
1699710483
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-050063 Issued in IL
Practice address
800 W Oakton St
Arlington Heights, IL 60004-4602
Phone
(847) 222-9901
Fax
(847) 222-9904
NPI assigned
Jun 17, 2006
Last updated
May 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-050063 IL Primary

Addresses

Primary practice location

800 W Oakton St
Arlington Heights, IL 60004-4602

Mailing address

765 Ela Rd
Ste 201
Lake Zurich, IL 60047-6305
Phone (847) 222-9901

Other identifiers 2

IdentifierTypeStateIssuer
036050063OtherILLICENSE #
110227219OtherILRAILROAD MEDICARE

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
I20090921000393 IL Practitioner - Internal Medicine 5597810796

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Saint Louis University School of Medicine, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

355 W Dundee Rd
Suite 110
Buffalo Grove, IL 60089-3500

765 Ela Rd
Suite 201
Lake Zurich, IL 60047-6305

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-050063ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Garretson, Homa & Kim, MD SC Internal Medicine Past Accepting new patients
Empower Life Chiropractic Corp PastSince May 17, 2020 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.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1699710483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 ELA RD",
            "address_2": "STE 201",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600476305",
            "telephone_number": "847-222-9901",
            "fax_number": "847-222-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W OAKTON ST",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600044602",
            "telephone_number": "847-222-9901",
            "fax_number": "847-222-9904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMA",
        "first_name": "THEODORE",
        "middle_name": "MORRISON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-050063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "036050063",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110227219",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.