Edward Kent Frye, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

036081908 Issued in IL

Practice address

455 W Court St
Ste 403
Kankakee, IL 60901-3679

Phone

(815) 939-3190

Fax

(815) 935-5101

NPI assigned

Nov 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

Urology

Education

University of Arkansas College of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prime Healthcare Illinois Medical Group LLCGroup PAC ID 5597275685, 278 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Presence St Marys Hospital Hospital, Kankakee, IL, CCN 140155
• Riverside Medical Center Hospital, Kankakee, IL, CCN 140186
• Iroquois Memorial Hospital Hospital, Watseka, IL, CCN 141353

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Prime Healthcare Illinois Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Des Plaines, IL
  • NPI 1023837689
  Medicare reassignment Care Compare group NPD
• United Shockwave Services, LTD.

  • Ambulatory Surgical Clinic/Center
  • La Grange, IL
  • NPI 1336526219
  NPD
• United Shockwave Services, LTD.

  • Urology Physician
  • Park Ridge, IL
  • NPI 1497132377
  NPD
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

• Iroquois Memorial Hospital and Resident Home

  • Critical Access Hospital
  • Watseka, IL
  • NPI 1629003470
  Care Compare affiliation
• Riverside Medical Center

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1538208210
  Care Compare affiliation
• St Marys Hospital - Kankakee LLC

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1467290809
  Care Compare affiliation

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314662400000",
    "number": "1952392557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 W COURT ST",
            "address_2": "STE 403",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013679",
            "telephone_number": "815-939-3190",
            "fax_number": "815-935-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 W COURT ST",
            "address_2": "STE 403",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013679",
            "telephone_number": "815-939-3190",
            "fax_number": "815-935-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYE",
        "first_name": "EDWARD",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2011-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036081908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03081908",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "IL1789",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IL1789002",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4600208",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Fosen, B.S
• Thomas Patrick Fosnaugh, PHARM.D.
• Gwendolyn J Franklin
• Traci L Freitas, DPT, CLT
• Leah Kirstine Frey
• Iga Fudyma
• Aaron Fuerst, PT
• Morgan Taylor Funk, AGPCNP-BC
• Amanda Jean Gaikwad, PT
• Martha Gainer, APN-FNP

• Urology Physician in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Urology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; 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.