SOUTHCARE FAMILY PRACTICE
NPI 1275729303
Preferred Provider Organization in Chicago, IL
NPI Status: Active since September 21, 2007
Contact Information
10627 S PULASKI RD
CHICAGO, IL
ZIP 60655
Phone: (773) 779-9300
Fax: (773) 779-5768
- Organization
- Preferred Provider Organization
- Accepts Insurance
About SOUTHCARE FAMILY PRACTICE
This page provides the complete NPI Profile along with additional information for Southcare Family Practice, a provider established in Chicago, Illinois operating as a Preferred Provider Organization. The healthcare provider is registered in the NPI registry with number 1275729303 assigned on September 2007. The practitioner's primary taxonomy code is 305R00000X with license number 036072512 (IL). The provider is registered as an organization and their NPI record was last updated 14 years ago. The provider's is doing business as Southcare Family Practice. The authorized official of this NPI record is Dr. Peter F Macentee M.d. (President)
- NPI
- 1275729303
- Provider Legal Name
- MACENTEE KNOX & VARGAS MDS
- Other Organization Name
- SOUTHCARE FAMILY PRACTICE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 10627 S PULASKI RD CHICAGO, IL 60655
- Location Phone
- (773) 779-9300
- Location Fax
- (773) 779-5768
- Mailing Address
- 10627 S PULASKI RD CHICAGO, IL 60655
- Mailing Phone
- (773) 779-9300
- Mailing Fax
- (773) 779-5768
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-21-2007
- Last Update Date
- 03-08-2011
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Preferred Provider Organization
- Taxonomy Code
- 305R00000X
- Type
- Managed Care Organizations
- License No.
- 036072512
- License State
- IL
- Taxonomy Description
- A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 305R00000X | Managed Care Organizations | Preferred Provider Organization | 036047977 (IL) |
| 2 | 305S00000X | Managed Care Organizations | Point of Service | 036063080 (IL) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - PPO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 750290 | MEDICARE PIN (08) | IL | |
| P09567 | MEDICARE PIN (08) | IL | |
| L77296 | MEDICARE PIN (08) | IL | |
| P09566 | MEDICARE PIN (08) | IL |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 7 | 5 | 7 | 2 | 9 | 3 | 0 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 14 | 5 | 14 | 2 | 18 | 3 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 4 + 5 + 1 + 4 + 2 + 1 + 8 + 3 + 0 + 24 = 57 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 57 = 3 | 3 | ||||||||
The NPI number 1275729303 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1467540567 | DR. RAFAEL J VARGAS-ZAPATA M.D. Individual | Family Medicine | 10627 S PULASKI RD CHICAGO, IL 60655 (773) 779-9300 |
| 1417045501 | DR. PETER F MACENTEE M.D. Individual | Family Medicine | 10627 S PULASKI RD CHICAGO, IL 60655 (773) 779-9300 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1275729303, enumerated in the NPI registry as an "organization" on September 21, 2007
The provider is located at 10627 S Pulaski Rd Chicago, Il 60655 and the phone number is (773) 779-9300
This medical organization specializes in Preferred Provider Organization with taxonomy code 305R00000X
The provider might be accepting Accepts: Aetna CVS Health, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on September 21, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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