Jonathan A. Holt, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036.162121 Issued in IL

Practice address

1893 Sheridan Rd
Highland Park, IL 60035-2628

Phone

(650) 450-8102

NPI assigned

Feb 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2023 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Shifu & Associates

  • Clinic/Center
  • Highland Park, IL
  • NPI 1376245456
  NPD Authorized official

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1720128259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 W END AVE",
            "address_2": "436",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031453",
            "telephone_number": "650-450-8102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1893 SHERIDAN RD",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352628",
            "telephone_number": "650-450-8102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "JONATHAN",
        "middle_name": "A.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.162121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX89800",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Hoffman Sr., LCSW
• Donald L Hoffman, DDS PHD
• Inna Hoffman, APN
• Jennifer N Hoffmann
• Holcomb Family Chiropractic
• Home of Friends Illinois
• Home Team Med Care, S.C.
• Kenneth Ford Horowitz, M.D.
• Stavroula Houmpavlis, PHARM.D
• Colleen Howe, CCC-SLP

• Internal Medicine Physician in Highland Park, IL
• Providers in Highland Park, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.