NPIMap

Individual provider Active NPI

Yekaterina Fayn, MD

  • Cardiovascular Disease Physician
  • Olney, IL
National Provider Identifier
1699934471
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036117305 Issued in IL
Practice address
800 E Locust St
Olney, IL 62450-2553
Phone
(618) 392-1139
Fax
(618) 392-1138
NPI assigned
Jun 5, 2008
Last updated
Nov 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 01069692A IN
Cardiovascular Disease Physician 207RC0000X 036117305 IL Primary

Addresses

Primary practice location

800 E Locust St
Olney, IL 62450-2553

Mailing address

800 E Locust St
Olney, IL 62450-2553
Phone (618) 392-1139

Other practice location 1

1205 Provident Drive
Suite A
Warsaw, IN 46580-3265
Phone (574) 269-8383

Other identifiers 6

IdentifierTypeStateIssuer
201025070MedicaidIN
036117305OtherILSTATE LICENSE
1699934471OtherILNPI NUMBER
036117305MedicaidIL
F400434935OtherILMEDICARE NUMBER
336078451OtherILCONTROLLED SUBSTANCE LICENSE

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
I20171214003136 IL Practitioner - Internal Medicine 8820276223 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians
Richland Memorial Hospital IncGroup PAC ID 3870565732, 107 clinicians

Practice addresses (Care Compare)

100 Lerna S Rd
Mattoon, IL 61938-9384
Phone (217) 258-5900

100 S Main St
West Salem, IL 62476-1202
Phone (618) 456-3727

101 Industry Rd
Bridgeport, IL 62417-2442
Phone (618) 945-3001

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

701 E Orange St
Hoopeston, IL 60942-1801
Phone (217) 283-5531

800 E Locust St
Olney, IL 62450-2553
Phone (618) 395-7340

900 E Scott St
Olney, IL 62450-2576
Phone (618) 395-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hoopeston Community Memorial Hospital Cardiovascular Disease Current Accepting new patients
Richland Memorial Hospital, Inc. CurrentSince Jan 11, 2021 Accepting new patients
Carle Health Medical Group Cardiovascular Disease CurrentSince Feb 5, 2024 Accepting new patients
Crawford Hospital District CurrentSince Jan 10, 2022 Accepting new patients
Crawford Hospital District CurrentSince Jan 10, 2022 Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Jul 21, 2021 Accepting new patients
Richland Memorial Hospital, Inc Current Accepting new patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Richland Memorial Hospital, Inc CurrentSince Jan 11, 2021 Accepting new patients
Crawford Hospital District Current Accepting new patients
Carle Health Care Incorporated Past Accepting new patients

Locations

101 Industry Rd
Bridgeport, IL 62417
Phone (618) 395-7340

834 N Seminary St
Ste 304
Galesburg, IL 61401
Phone (309) 342-2144

834 N Seminary St
Ste 404
Galesburg, IL 61401
Phone (309) 343-3444

834 N Seminary St
Ste 405
Galesburg, IL 61401
Phone 3093435114 ext. 61072

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

800 E Locust St
Olney, IL 62450
Phone (618) 395-2131

900 E Scott St
Olney, IL 62450
Phone (618) 345-1000

1000 N Allen St
Robinson, IL 62454
Phone (618) 544-3131

1201 Ricker Rd
Salem, IL 62881
Phone (618) 548-3194

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

100 S Main St
West Salem, IL 62476
Phone (618) 456-3727

Interoperability endpoints

  • Direct secure messaging: yfayn@yourcarecommunity.org

Organizations & group practices 11

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 9

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": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1699934471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E LOCUST ST",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624502553",
            "telephone_number": "618-392-1139",
            "fax_number": "618-392-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E LOCUST ST",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624502553",
            "telephone_number": "618-392-1139",
            "fax_number": "618-392-1138"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1205 Provident Drive",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "IN",
            "postal_code": "465803265",
            "country_code": "US",
            "telephone_number": "574-269-8383",
            "fax_number": "574-269-8384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAYN",
        "first_name": "YEKATERINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01069692A",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036117305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201025070",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036117305",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1699934471",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036117305",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "F400434935",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE LICENSE",
            "identifier": "336078451",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, IL

Sources for this page

Verify at the official NPI Registry.