Peter Wesley McCauley Sr., M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Practice address

675 W North Ave
Lower Level
Melrose Park, IL 60160-1634

Phone

(708) 531-5463

Fax

(708) 450-1150

NPI assigned

Feb 10, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: peter.mc.cauley.1@15548.direct.athenahealth.com

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.

• Tca Health Inc NFP

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1184757353

  IL

  Medicare reassignment NPD
• Tca Health Inc NFP

  • Federally Qualified Health Center (FQHC)
  • Hammond, IN
  • NPI 1093404576
  NPD

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

{
    "created_epoch": "1171065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962543934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 S PRAIRIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163904",
            "telephone_number": "312-567-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE",
            "address_2": "LOWER LEVEL",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601634",
            "telephone_number": "708-531-5463",
            "fax_number": "708-450-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAULEY",
        "first_name": "PETER",
        "middle_name": "WESLEY",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01037419A",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salome Elizabeth Mathews
• Richard C. Mattis, M.D.
• Samreen Mattoo, M.D.
• Alexandria McBride, M.S.
• Julia McCann-Khludenev, DNP, FNP-BC
• John E McConnell, DO
• Kim McCoy
• Reginald James McCoy Jr., CPHT, MBA, MPA.
• Tameka Tyrese McFarland, BA
• Ryan McGuire, OTR/L

• All providers in Melrose Park, IL
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.