NPIMap

Individual provider Active NPI

Sergei G Lipov, M.D.

  • Internal Medicine Physician
  • Elgin, IL
National Provider Identifier
1982634127
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036065857 Issued in IL
Practice address
1975 Lin Lor LN
Suite 285
Elgin, IL 60123-4902
Phone
(847) 608-7542
Fax
(847) 608-9812
NPI assigned
Jul 4, 2006
Last updated
Feb 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036065857 IL Primary

Addresses

Primary practice location

1975 Lin Lor LN
Suite 285
Elgin, IL 60123-4902

Mailing address

PO Box 5478
Elgin, IL 60121-5478
Phone (847) 608-7542

Other identifiers 1

IdentifierTypeStateIssuer
036065857MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080410000616 IL Practitioner - Internal Medicine 1951488238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1975 Lin Lor LN
Suite 285
Elgin, IL 60123-4964
Phone (847) 608-7542

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
23.02 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
76.72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036065857ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internamed, P.C. Internal Medicine CurrentSince Aug 1, 2001 Accepting new patients
T Win MDSC Internal Medicine Past Accepting new patients

Locations

1975 Lin Lor Ln
Ste 285
Elgin, IL 60123
Phone (847) 608-7542

Interoperability endpoints

  • Direct secure messaging: slipov288499@direct.myadvocateaurora.org

Organizations & group practices 2

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 8

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1982634127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5478",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601215478",
            "telephone_number": "847-608-7542",
            "fax_number": "847-608-9812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 LIN LOR LN",
            "address_2": "SUITE 285",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234902",
            "telephone_number": "847-608-7542",
            "fax_number": "847-608-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPOV",
        "first_name": "SERGEI",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036065857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036065857",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.