Active NPI
Gabriel Lathrop, DO, MS
- Emergency Medicine Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 125078687
- Practice address
- 5140 N California Ave
Chicago, IL 60625-3645 - Phone
- (773) 878-8200
- NPI assigned
- Mar 5, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Chicago, IL
- NPI 1467468280
IL, Single Specialty
-
- Emergency Medical Services (Emergency Medicine) Physician
- Chicago, IL
- NPI 1760587703
IL, Single Specialty
-
- Primary Care Clinic/Center
- Chicago, IL
- NPI 1992053029
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Anthony Emergency Services Physician GroupFoundation for Emergency Services
Practice addresses (Care Compare)
2875 W 19TH St
Chicago, IL 60623-3501
Phone (773) 484-1000
326 W 64TH St
Chicago, IL 60621-3114
Phone (773) 962-3900
Hospital & facility affiliations
- Saint Anthony Hospital
- St Bernard Hospital
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240212003558 | IL | Practitioner - Emergency Medicine | 1759724230 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125078687 | IL | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foundation for Emergency Services | Current | Accepting new patients | |
| St Anthony Emergency Services Physician Group | Single Specialty | Current | Accepting new patients |
| Foundation for Emergency Services | Single Specialty | Current | Accepting new patients |
Locations
2875 W 19th St
Chicago, IL 60623
Phone (773) 484-4300
326 W 64th St
Chicago, IL 60621
Phone (773) 962-3900
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 125078687 | IL | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
5140 N California Ave
Chicago, IL 60625-3645
Mailing address
5140 N California Ave
Chicago, IL 60625-3645
Phone (773) 878-8200
Other practice location 1
200 Mullins Dr
Lebanon, OR 97355-3983
Phone (541) 259-0235
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 24, 2021.
{
"created_epoch": "1551744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624492800000",
"number": "1851859367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5140 N CALIFORNIA AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606253645",
"telephone_number": "773-878-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5140 N CALIFORNIA AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606253645",
"telephone_number": "773-878-8200"
}
],
"practiceLocations": [
{
"address_1": "200 Mullins Dr",
"address_purpose": "LOCATION",
"city": "Lebanon",
"state": "OR",
"postal_code": "973553983",
"country_code": "US",
"telephone_number": "541-259-0235",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LATHROP",
"first_name": "GABRIEL",
"name_prefix": "Mr.",
"credential": "DO, MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-05",
"last_updated": "2021-06-24",
"certification_date": "2021-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": "IL",
"license": "125078687",
"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 Jun 24, 2021; 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.