Individual provider Active NPI

Joseph Robert Holtman Jr., MD

  • Pain Medicine (Anesthesiology) Physician
  • Maywood, IL
National Provider Identifier
1811089600
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
036124722 Issued in IL
Practice address
2160 S 1St Ave
Maywood, IL 60153
Phone
(708) 216-9000
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 32026 KY
Pain Medicine (Anesthesiology) Physician 207LP2900X 32026 KY
Pain Medicine (Anesthesiology) Physician 207LP2900X 036124722 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153

Mailing address

2 Westbrook Corporate Ctr Ste 600
Westchester, IL 60154-5716
Phone (708) 216-5092

Other identifiers 1

IdentifierTypeStateIssuer
64320260MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jholtman35021@direct.luhs.org Other

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100316000909 IL Practitioner - Pain ManagementPractitioner - AnesthesiologyPractitioner - Interventional Pain Management 0941335970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
University of Kentucky College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

300 N York Rd
Elmhurst, IL 60126-2318
Phone (630) 833-0630

6800 N Frontage Rd
Burr Ridge, IL 60527-7819
Phone (708) 327-1000

Hospital & facility affiliations

  • Loyola University Medical Center Hospital, Maywood, IL, CCN 140276

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32026KYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center Current Accepting new patients
Loyola University Medical Center CurrentSince Mar 1, 2010 Accepting new patients
Loyola University Medical Center CurrentSince Mar 1, 2010 Accepting new patients
Kentucky Medical Services Foundation, Inc Anesthesiology Current Accepting new patients

Locations

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

2 Westbrook Corporate Ctr
Ste 600
Westchester, IL 60154
Phone (708) 216-5092

310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

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 2

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1811089600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WESTBROOK CORPORATE CTR STE 600",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601545716",
            "telephone_number": "708-216-5092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTMAN",
        "first_name": "JOSEPH",
        "middle_name": "ROBERT",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "32026",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "KY",
            "license": "32026",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036124722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64320260",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jholtman35021@direct.luhs.org",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR IPA",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.