Individual provider Active NPI

Tom K Stathopoulos, M.D.

  • Cardiovascular Disease Physician
  • Greeneville, TN
National Provider Identifier
1922053511
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
73862 Issued in TN
Practice address
1410 Tusculum Blvd Ste 1500
Greeneville, TN 37745-5810
Phone
(423) 638-2270
Fax
(423) 638-2205
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036098988 IL
Cardiovascular Disease Physician 207RC0000X 73862 TN Primary

Addresses

Primary practice location

1410 Tusculum Blvd Ste 1500
Greeneville, TN 37745-5810

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111

Other practice location 1

1555 Barrington Rd
Suite 2300B
Hoffman Estates, IL 60169-1019
Phone (847) 843-7030

Other practice location 2

1901 S Shady St Ste 1
Mountain City, TN 37683-2021
Phone (423) 727-6674

Other practice location 3

10370 Haligus Rd Ste 200
Huntley, IL 60142-9582
Phone (815) 759-8070

Other practice location 4

360 Station Dr Fl 3
Crystal Lake, IL 60014-7978
Phone (815) 759-8070

Other practice location 5

2428 Knob Creek Rd Ste 201
Johnson City, TN 37604-2396
Phone (423) 282-5054

Other practice location 6

4309 W Medical Center Dr Ste A200
McHenry, IL 60050
Phone (815) 759-8070

Other practice location 7

1410 Tusculum Blvd Ste 1200
Greeneville, TN 37745-5815
Phone (423) 787-7100

Other identifiers 2

IdentifierTypeStateIssuer
1740231505OtherILNPI GROUP PRACTICE
036098988OtherILSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050408001016 IL Practitioner - Cardiovascular Disease (Cardiology) 1153368345 Reassigns benefits to 1 organization
I20250922000219 TN Practitioner - Cardiovascular Disease (Cardiology) 1153368345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Cardiology ServicesGroup PAC ID 5799970281, 137 clinicians

Practice addresses (Care Compare)

1410 Tusculum Blvd
Suite 1500
Greeneville, TN 37745-5810
Phone (423) 638-2270

Hospital & facility affiliations

  • Greeneville Community Hospital Hospital, Greeneville, TN, CCN 440050
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
73862TNMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince May 1, 2019 Accepting new patients
Central Dupage Physician Group CurrentSince May 1, 2019 Accepting new patients
Wellmont Cardiology Services Cardiovascular Disease CurrentSince Oct 1, 2025 Accepting new patients
Dupage Medical Group LTD PastSince Apr 1, 2009 Accepting new patients
Valley Medical & Cardiac Clinic, LTD. PastSince Aug 1, 2007 Accepting new patients
Advocate Health and Hospitals Corporation Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

360 Station Dr
Fl 3
Crystal Lake, IL 60014
Phone (815) 759-8070

11650 S State Route 47
Huntley, IL 60142
Phone (847) 802-7300

10370 Haligus Rd
Ste 200
Huntley, IL 60142
Phone (815) 759-8070

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

4309 W Medical Center Dr
Ste A200
McHenry, IL 60050
Phone (815) 759-4699

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

3707 Doty Rd
Woodstock, IL 60098
Phone (815) 206-1068

1410 Tusculum Blvd
Ste 1200
Greeneville, TN 37745
Phone (423) 638-2270

1410 Tusculum Blvd
Ste 1500
Greeneville, TN 37745
Phone (423) 638-2270

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

2428 Knob Creek Rd
Ste 201
Johnson City, TN 37604
Phone (423) 262-4400

2050 Meadowview Pkwy
Kingsport, TN 37660

1901 S Shady St
Ste 1
Mountain City, TN 37683
Phone (423) 727-1103

Organizations & group practices 6

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 5

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1922053511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-952-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 TUSCULUM BLVD STE 1500",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377455810",
            "telephone_number": "423-638-2270",
            "fax_number": "423-638-2205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1555 Barrington Rd",
            "address_2": "Suite 2300B",
            "address_purpose": "LOCATION",
            "city": "Hoffman Estates",
            "state": "IL",
            "postal_code": "601691019",
            "country_code": "US",
            "telephone_number": "847-843-7030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1901 S Shady St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Mountain City",
            "state": "TN",
            "postal_code": "376832021",
            "country_code": "US",
            "telephone_number": "423-727-6674",
            "fax_number": "423-727-1268",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10370 Haligus Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601429582",
            "country_code": "US",
            "telephone_number": "815-759-8070",
            "fax_number": "815-759-4931",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "360 Station Dr Fl 3",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600147978",
            "country_code": "US",
            "telephone_number": "815-759-8070",
            "fax_number": "815-759-4931",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2428 Knob Creek Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042396",
            "country_code": "US",
            "telephone_number": "423-282-5054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4309 W Medical Center Dr Ste A200",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "60050",
            "country_code": "US",
            "telephone_number": "815-759-8070",
            "fax_number": "815-759-4931",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1410 Tusculum Blvd Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Greeneville",
            "state": "TN",
            "postal_code": "377455815",
            "country_code": "US",
            "telephone_number": "423-787-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STATHOPOULOS",
        "first_name": "TOM",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036098988",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "73862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP PRACTICE",
            "identifier": "1740231505",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036098988",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeneville, TN

Sources for this page

Verify at the official NPI Registry.