NPIMap

Individual provider Active NPI

Sebastian Joseph, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1790004380
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
336.086678 Issued in IL
Practice address
10830 S Halsted St
Chicago, IL 60628-3126
Phone
(773) 785-8000
Fax
(312) 533-2818
NPI assigned
May 22, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 336.086678 IL Primary

Addresses

Primary practice location

10830 S Halsted St
Chicago, IL 60628-3126

Mailing address

PO Box 3855
Carol Stream, IL 60132-3855
Phone (773) 785-8000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sjoseph279820@direct.myadvocateaurora.org Direct
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20100715000051 IL Practitioner - Family Practice 0042342800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seby S CGroup PAC ID 4486835139, 4 clinicians

Practice addresses (Care Compare)

10830 S Halsted St
Chicago, IL 60628-3126
Phone (773) 785-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
336.086678ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roseland Community Hospital Association Current Accepting new patients
Seby S C Family Medicine CurrentSince Sep 6, 2010 Accepting new patients
Emergency Medical Specialist, S.C Past Accepting new patients
Emergency Medical Specialists, II, S.C. Past Accepting new patients

Locations

10830 S Halsted St
Chicago, IL 60628
Phone (773) 264-1400

4115 Fairview Ave
Downers Grove, IL 60515
Phone (630) 968-1881

Interoperability endpoints

  • Direct secure messaging: sjoseph@roselandhospital.medalliesdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1274486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1790004380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3855",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601323855",
            "telephone_number": "773-785-8000",
            "fax_number": "312-533-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10830 S HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606283126",
            "telephone_number": "773-785-8000",
            "fax_number": "312-533-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "SEBASTIAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-22",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "336.086678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjoseph279820@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10830 S Halsted St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606283126",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "10830 S Halsted St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606283126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.