Individual provider Active NPI

Paul Young Edemobi

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1982229258
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036164703 Issued in IL
Practice address
1500 S Fairfield Ave
Chicago, IL 60608-1782
Phone
(571) 242-6491
NPI assigned
Jun 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036164703 IL Primary

Addresses

Primary practice location

1500 S Fairfield Ave
Chicago, IL 60608-1782

Mailing address

26467 Network PL
Chicago, IL 60673-1264
Phone (773) 542-2000

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
I20230801001554 IL Practitioner - Emergency Medicine 9537583380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians

Practice addresses (Care Compare)

1500 S Fairfield Ave
Chicago, IL 60608-1782
Phone (773) 542-2000

Hospital & facility affiliations

  • Holy Cross Hospital Hospital, Chicago, IL, CCN 140133
  • Mt Sinai Hospital Medical Center Hospital, Chicago, IL, CCN 140018

Merit-based Incentive Payment System (MIPS)

Final score
93.41 of 100Reported as group
Quality
86.81
Improvement activities
40
Cost
77.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036164703ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Illinois, LLP Emergency Medicine CurrentSince Jul 19, 2023 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Jul 19, 2023 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine Current Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

1500 S Fairfield Ave
Chicago, IL 60608
Phone (773) 257-5701

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

Organizations & group practices 3

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": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1982229258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26467 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731264",
            "telephone_number": "773-542-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S FAIRFIELD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081782",
            "telephone_number": "571-242-6491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDEMOBI",
        "first_name": "PAUL YOUNG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-12",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036164703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.