Kevin Sean Gavin, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

016004743 Issued in IL

Practice address

1219 S Main St
Algonquin, IL 60102-2741

Phone

(847) 458-1800

Fax

(847) 458-8447

NPI assigned

Jul 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 3

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

William M. Scholl College of Podiatric Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Podiatric Management Systems LLC

  • Primary Podiatric Medicine Podiatrist
  • Lake Zurich, IL
  • NPI 1396968053
  NPD (past)
• Podiatric Management Systems LLC

  • Podiatrist
  • Wheeling, IL
  • NPI 1972119360
  NPD (past)

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

• Central Dupage Hospital Association

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1861424624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 S MAIN ST",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601022741",
            "telephone_number": "847-458-1800",
            "fax_number": "847-458-8447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 S MAIN ST",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601022741",
            "telephone_number": "847-458-1800",
            "fax_number": "847-458-8447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1666 S Eastwood Dr",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "IL",
            "postal_code": "600984655",
            "country_code": "US",
            "telephone_number": "815-338-6800",
            "fax_number": "815-338-7105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAVIN",
        "first_name": "KEVIN",
        "middle_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016004743",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016004743",
            "primary": true
        },
        {
            "code": "213EP0504X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Public Medicine",
            "state": "IL",
            "license": "016004743",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "IL",
            "license": "016004743",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "IL",
            "license": "016004743",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "IL",
            "license": "016004743",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01606879",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480023961",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5090108",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Dunn Gara, PSY.D.
• Ashley Gardner
• Kelly Anne Gardynski, DNP, APRN, CPNP-PC
• Jennifer E Garofalo, ATC
• Gary M Kohn MD PA
• Senait Gebretsadik
• Georgetown Home Health Care Inc
• Georgetown Home Health Care, Inc.
• Amanda Elizabeth Gerke, DC
• Deborah A Gibson, PHARMD

• Podiatrist in Algonquin, IL
• Providers in Algonquin, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2020; 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.

Verify at the official NPI Registry.