Active NPI
Thomas Joseph Cellini, DO
- Diagnostic Radiology Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 036161203
- Practice address
- 1653 W Congress Pkwy
Chicago, IL 60612 - Phone
- (549) 531-2942
- NPI assigned
- May 15, 2017
- Last updated
- Sep 28, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 125071114 | IL | |
| Diagnostic Radiology Physician | 2085R0202X | 036161203 | IL | Primary |
Addresses
Primary practice location
1653 W Congress Pkwy
Chicago, IL 60612
Mailing address
250 E Superior St Ste 4-2304
Chicago, IL 60611-2914
Phone (312) 472-0436
Other practice location 1
836 W Wellington Ave
Chicago, IL 60657-5147
Phone (773) 296-5424
Other practice location 2
836 W Wellington Ave
Chicago, IL 60657-5147
Phone (773) 296-5424
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Philadelphia College of Osteopathic Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Navarre PL
Suite 6655
South Bend, IN 46601-1174
Phone (574) 647-6850
1020 High Rd
Bremen, IN 46506-1093
Phone (574) 546-2211
1115 Professional Dr
Goshen, IN 46526-3800
Phone (574) 364-4850
1135 Professional Dr
Goshen, IN 46526-3800
Phone (574) 364-4000
200 High Park Ave
Goshen, IN 46526-4810
Phone (574) 535-2693
303 S Nappanee St
Elkhart Clinic
Elkhart, IN 46514-2066
Phone (574) 296-3365
600 E Blvd
Elkhart, IN 46514-2483
Phone (574) 294-2621
701 S Health Pkwy
Three Rivers, MI 49093-8352
Phone (269) 278-1145
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036161203 | IL | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Radiology, Inc | Diagnostic Radiology | Current | Accepting new patients |
| Beacon Health, LLC | Diagnostic Radiology | Current | Accepting new patients |
| Beacon Health, LLC | Diagnostic Radiology | Current | Accepting new patients |
| Memorial Lighthouse Imaging LLC | Diagnostic Radiology | Past | Accepting new patients |
Locations
1020 High Rd
Bremen, IN 46506
Phone (574) 309-9967
1020 High Rd
#O
Bremen, IN 46506
Phone (574) 284-3086
303 S Nappanee St
Elkhart, IN 46514
600 East Blvd
Elkhart, IN 46514
Phone (574) 294-2621
1115 Professional Dr
Goshen, IN 46526
Phone (574) 364-4850
200 High Park Ave
Goshen, IN 46526
Phone (219) 533-2141
2222 Rieth Blvd
Ste 101
Goshen, IN 46526
Phone (574) 875-0881
6901 N Main St
Granger, IN 46530
Phone (574) 647-2900
102 E Culver Rd
Knox, IN 46534
Phone (574) 772-1580
1331 State St
Laporte, IN 46350
Phone (219) 326-2415
620 W Edison Rd
Ste 110
Mishawaka, IN 46545
Phone 5742581100 ext. 239
615 N Michigan St
South Bend, IN 46601
Phone (574) 647-1000
701 S Health Parkway
Three Rivers, MI 49093
Phone (269) 273-9691
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Beacon Imaging Mishawaka
- Diagnostic Radiology Physician
- Mishawaka, IN
- NPI 1912796699
-
- Diagnostic Ultrasound Physician
- South Bend, IN
- NPI 1730225848
Diagnostic Radiology
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Bremen, IN
- NPI 1568417004
-
- General Acute Care Hospital
- Elkhart, IN
- NPI 1477551489
-
- General Acute Care Hospital
- Goshen, IN
- NPI 1740268846
-
- General Acute Care Hospital
- South Bend, IN
- NPI 1295772093
-
dba Memorial Epworth Center
- Psychiatric Hospital Unit
- South Bend, IN
- NPI 1376841395
-
dba Beacon Granger Hospital, A Memorial Hospital Extension
- General Acute Care Hospital
- Granger, IN
- NPI 1881177756
-
dba Three Rivers Health
- General Acute Care Hospital
- Three Rivers, MI
- NPI 1568739423
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664323200000",
"number": "1790212363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 E SUPERIOR ST STE 4-2304",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112914",
"telephone_number": "312-472-0436",
"fax_number": "312-472-0480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1653 W CONGRESS PKWY",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60612",
"telephone_number": "549-531-2942"
}
],
"practiceLocations": [
{
"address_1": "836 W Wellington Ave",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606575147",
"country_code": "US",
"telephone_number": "773-296-5424",
"fax_number": "773-296-5265",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "836 W Wellington Ave",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606575147",
"country_code": "US",
"telephone_number": "773-296-5424",
"fax_number": "773-296-5265",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CELLINI",
"first_name": "THOMAS",
"middle_name": "JOSEPH",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-15",
"last_updated": "2022-09-28",
"certification_date": "2022-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "125071114",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "036161203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.