NPIMap

Individual provider Active NPI

John A Panozzo, M.D.

  • Family Medicine Physician
  • Orland Park, IL
National Provider Identifier
1841238029
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036105009 Issued in IL
Practice address
16513 106TH CT
Orland Park, IL 60467-4545
Phone
(708) 364-8100
Fax
(708) 364-1774
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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 036105009 IL Primary

Addresses

Primary practice location

16513 106TH CT
Orland Park, IL 60467-4545

Mailing address

16513 106TH CT
Orland Park, IL 60467-4545
Phone (708) 364-8100

Other identifiers 1

IdentifierTypeStateIssuer
036105009MedicaidIL

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
I20100312000972 IL Practitioner - Family Practice 9830224070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Health Associates PCGroup PAC ID 0749254845, 9 clinicians

Practice addresses (Care Compare)

10300 Village Circle Dr
Palos Park, IL 60464-3541
Phone (708) 361-6091

16512 S 106TH CT
Orlando Park, IL 60467-4547
Phone (708) 364-8323

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036105009ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Health Associates PC Family Medicine CurrentSince Aug 5, 2002 Accepting new patients

Locations

16513 106th Ct
Orland Park, IL 60467
Phone (708) 364-8100

16512 106th Ct
Orland Park, IL 60467
Phone (708) 364-8323

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JGEBDA
  • Direct secure messaging: john.panozzo@pha16512.eclinicaldirectplus.com

Organizations & group practices 1

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1841238029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16513 106TH CT",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604674545",
            "telephone_number": "708-364-8100",
            "fax_number": "708-364-1774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16513 106TH CT",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604674545",
            "telephone_number": "708-364-8100",
            "fax_number": "708-364-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANOZZO",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036105009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105009",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.