Individual provider Active NPI

Jared Allan Kalina, DO

  • Interventional Pain Medicine Physician
  • Forest Park, IL
National Provider Identifier
1871741132
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
036119113 Issued in IL
Practice address
334 Circle Ave
Forest Park, IL 60130-1610
Phone
(708) 628-8574
Fax
(866) 282-9069
NPI assigned
Aug 28, 2008
Last updated
Nov 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 036119113 IL Primary

Addresses

Primary practice location

334 Circle Ave
Forest Park, IL 60130-1610

Mailing address

625 S Oak Park Ave
Oak Park, IL 60304-1213
Phone (708) 628-8574

Other practice location 1

625 S Oak Park Ave
Oak Park, IL 60304-1213
Phone (773) 899-2261

Other identifiers 1

IdentifierTypeStateIssuer
036119113OtherILPHYSICIAN LICENSE

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
I20091208000349 IL Practitioner - Pain ManagementPractitioner - Anesthesiology 7618016478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
University of Wisconsin School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

334 Circle Ave
Forest Park, IL 60130-1610
Phone (708) 628-8574

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Loretto Hospital Interventional Pain Medicine Current Accepting new patients
Elmhurst Anesthesiologists, PC Past Accepting new patients
Alpha Rehabilitation Medical Center LTD PastSince Feb 1, 2015 Accepting new patients

Locations

645 S Central Ave
Chicago, IL 60644
Phone (773) 626-4300

Interoperability endpoints

  • Direct secure messaging: jared.kalina@loretto.medalliesdirect.net
  • Direct secure messaging: kalinajared@direct.meditouchehr.com

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.

Hospital & facility affiliations 1

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": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1871741132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 S OAK PARK AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041213",
            "telephone_number": "708-628-8574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 CIRCLE AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301610",
            "telephone_number": "708-628-8574",
            "fax_number": "866-282-9069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 S Oak Park Ave",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603041213",
            "country_code": "US",
            "telephone_number": "773-899-2261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALINA",
        "first_name": "JARED",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-28",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "036119113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "036119113",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Park, IL

Sources for this page

Verify at the official NPI Registry.