Ted G Van Acker, D.O.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Practice address

220 N Park Ave
Suite 2
Herrin, IL 62948-3150

Phone

(618) 942-3344

Fax

(618) 942-5045

NPI assigned

Jun 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Dermatology

Education

Michigan State University College of Osteopathic Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Illinois Dermatology, PCGroup PAC ID 2769479203, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Herrin Hospital Hospital, Herrin, IL, CCN 140011

Merit-based Incentive Payment System (MIPS)

Final score

89.81 of 100Reported as group

Quality

79.62

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Southern Illinois Dermatology, PC

  • Dermatology Physician
  • Herrin, IL
  • NPI 1306870233
  Medicare reassignment Care Compare group NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southern Illinois Hospital Services

  dba Herrin Hospital

  • General Acute Care Hospital
  • Herrin, IL
  • NPI 1528158573
  Care Compare affiliation

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720025562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N PARK AVE",
            "address_2": "SUITE 2",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483150",
            "telephone_number": "618-942-3344",
            "fax_number": "618-942-5045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N PARK AVE",
            "address_2": "SUITE 2",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483150",
            "telephone_number": "618-942-3344",
            "fax_number": "618-942-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN ACKER",
        "first_name": "TED",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GRP #",
            "identifier": "CB3700",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK PROV NUMBER",
            "identifier": "290730",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "10007459",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA PROVIDER NUMBER",
            "identifier": "L84853",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• TS Onsite Mental Health
• Francis H Tsung, M.D.
• Joseph C Tsung, M.D.
• Ann Margaret Unger, M.S., CCC-SLP
• Laura Utley, APN
• Richard P Vicenzi, ATHLETIC TRAINER
• Kara Iris Abigail Vidales, RBT
• Dawn Violett
• Renee Delene Violett
• Vna Homecare, Inc. (VNA-TIP HomeCare)

• Dermatology Physician in Herrin, IL
• Providers in Herrin, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.