CARLY COOPER APRN
NPI 1063172617
Nurse Practitioner in Lake Forest, IL
About Carly Cooper Aprn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CARLY COOPER APRN (NPI 1063172617) is an individual nurse practitioner in Lake Forest, Illinois, licensed in Illinois (209021184) and active in the NPI registry since December 2021. She is enrolled in Medicare PECOS, is affiliated with Northwestern Medicine Mchenry, and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Carly Cooper Aprn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Carly Cooper reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Carol Stream, IL 60122
- Reassigned Medicare billing, Illinois enrollment
- 4,817 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Northwestern Medicine Mchenry
Acute Care Hospitals · Mchenry, ILNorthwestern Lake Forest Hospital
Acute Care Hospitals · Lake Forest, ILNorthwestern Medicine Delnor Community Hospital
Acute Care Hospitals · Geneva, ILNorthwestern Medicine Central Dupage Hospital
Acute Care Hospitals · Winfield, ILNorthwestern Memorial Hospital
Acute Care Hospitals · Chicago, ILPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 60045 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LAKE FOREST, IL 60045
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Carly Cooper's NPI number?
The NPI number for Carly Cooper is 1063172617. It was assigned to this individual provider in the NPPES registry on December 22, 2021.
Where is Carly Cooper located?
Carly Cooper practices at 1000 N Westmoreland Rd, Lake Forest, IL 60045. The listed phone number is (847) 234-5600.
What is Carly Cooper's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Carly Cooper enrolled in Medicare?
Yes. Carly Cooper is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Carly Cooper's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Carly Cooper reassigns Medicare benefits to Northwestern Medical Faculty Foundation (Carol Stream, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carly Cooper's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Carly Cooper affiliated with any hospitals?
According to CMS data, Carly Cooper is affiliated with Northwestern Medicine Mchenry, Northwestern Lake Forest Hospital, Northwestern Medicine Delnor Community Hospital, Northwestern Medicine Central Dupage Hospital and Northwestern Memorial Hospital.
When was this NPI record last updated?
The NPPES record for Carly Cooper was last updated on March 31, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Carly Cooper, APRN · NPI 1063172617
Nurse Practitioner physician in Lake Forest, Illinois. Individual provider, active in the CMS NPPES registry since December 22, 2021.
## Identity
- **NPI:** 1063172617 (Entity type: Individual)
- **Enumerated:** December 22, 2021
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 209021184 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 1000 N WESTMORELAND RD, Lake Forest, IL 60045-1658
- **Phone:** (847) 234-5600
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Northwestern Medical Faculty Foundation (NPI 1346235314, Carol Stream, IL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** March 31, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1063172617) · Data from the CMS NPPES public registry.