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JACOB KALLIATH D.O.
NPI 1134569395
Internal Medicine in Olympia Fields, IL

Active since July 02, 2013PECOS EnrolledAccepts Medicare Assignment
20201 CRAWFORD AVE, OLYMPIA FIELDS, IL 60461(708) 679-2160(708) 679-2161 Get Directions Write a Review

NPPES record last updated: October 30, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 30, 2020, Sep 24, 2018, Jul 27, 2018 (3 updates tracked since 2018).

About Jacob Kalliath D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB KALLIATH D.O. (NPI 1134569395) is an individual internal medicine provider in Olympia Fields, Illinois, licensed in Illinois (12506386) and active in the NPI registry since July 2013. He is enrolled in Medicare PECOS, is affiliated with Lake Chelan Community Hospital, and maintains a secondary practice location in Mishawaka.

NPPES Registry Identity

NPI1134569395
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameJACOB KALLIATHCredential: D.O.
Location Address20201 CRAWFORD AVEOlympia Fields, IL 60461
Mailing Address10624 S. Eastern Ave #263aHenderson, NV 89052 · (760) 684-0407 · Fax (800) 604-6214
Phone(708) 679-2160
Fax(708) 679-2161
Sole ProprietorYes
Medical School CMSNova Southeastern College Of Osteo MedicineGraduated 2013
Enumeration DateJuly 2, 2013
Last NPPES UpdateOctober 30, 20203 updates tracked since enumeration
NPPES CertifiedOctober 30, 2020
✔ NPI 1134569395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in IL · 12506386✔ Licensed in IN · 02005206A✔ Licensed in CO · DR0057617
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedHospitalistTaxonomy 208M00000X · License 036138730 (IL)
20201 CRAWFORD AVE, Olympia Fields, IL 60461
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Secondary Practice Location 1

Location 14455 Edison Lakes PkwyMishawaka, IN 46545-1442 · Phone (574) 231-6134 · Fax (574) 231-6845

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

Jacob Kalliath D.o. 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.

PECOS PAC ID4486947421
PECOS Enrollment IDI20170209000508
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

5

Medicare enrollment records show Jacob Kalliath reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Swedish Covenant Management Services, Inc.
31 mi
Obstetrics & Gynecology
5140 N CALIFORNIA AVE
Chicago, IL 60625
  • Reassigned Medicare billing, Illinois enrollment
  • 350 clinicians in this Medicare group
NPI 1760432348 (847) 570-2040
Light Matter Solutions LLC
185 mi
Internal Medicine
333 E 2ND ST
Richland Center, WI 53581
  • Reassigned Medicare billing, Wisconsin enrollment
NPI 1457816332 (702) 453-3799
Rural Physicians Group-Pannu PLLC
912 mi
Hospitalist
5575 DTC PKWY STE 225
Greenwood Village, CO 80111
  • Reassigned Medicare billing, Wisconsin enrollment
  • 64 clinicians in this Medicare group
NPI 1891236584 (303) 390-1924
La Paz Regional Hospital, Inc.
1,511 mi
Rural Health
39726 HARQUAHALA ROAD
Salome, AZ 85348
  • Reassigned Medicare billing, Arizona enrollment
  • Also billed through NPI 1053684555 (Arizona)
  • 113 clinicians in this Medicare group
NPI 1629093539 (928) 859-3460
Chelan County Public Hospital District No 2
1,636 mi
Rural Health
110 S APPLE BLOSSOM DR
Chelan, WA 98816
  • Reassigned Medicare billing, Washington enrollment
  • 154 clinicians in this Medicare group
NPI 1124438312 (509) 682-3300

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 8

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
224 services115 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
165 services143 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
139 services125 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
138 services84 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
72 services33 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
38 services19 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lake Chelan Community Hospital

Critical Access Hospitals · Chelan, WA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number501334
Location110 S Apple Blossom DrChelan, WA 98816 · Chelan County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60461 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$138.86 typical visit price
range $60.08 – $183.39
Typical copayment $34.71 (range $15.02 – $45.84)
Most-billed visit code 99204
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers22 claims22 services$16.91 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers22 claims22 services$98.08 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

CHINTAN SHAH DO
Hospitalist
20201 CRAWFORD AVE
OLYMPIA FIELDS, IL 60461
Cook County (708) 747-4000
MICHAEL JOSEPH MULLAN II PTA
Physical Therapy Assistant
20201 CRAWFORD AVE
OLYMPIA FIELDS, IL 60461
Cook County (708) 852-2540
MARIA STEPHANIE TICSA
Student in an Organized Health Care Education/Training Program
20201 CRAWFORD AVE
OLYMPIA FIELDS, IL 60461
Cook County (708) 747-4000
DR. TONI SCOTT-TERRY MD
Obstetrics & Gynecology
20201 CRAWFORD AVE
OLYMPIA FIELDS, IL 60461
Cook County (708) 679-2160
DR. JOSEPH JOHN ZANGHI D.O.
Urology
20201 CRAWFORD AVE, ATTN: POSTDOCTORAL EDUCATION
OLYMPIA FIELDS, IL 60461
Cook County (708) 747-4000
CONSULTANTS IN PATHOLOGY SC
Pathology (Anatomic Pathology & Clinical Pathology)
20201 CRAWFORD AVE
OLYMPIA FIELDS, IL 60461
Cook County (708) 747-4000
SAMUEL L MACAGBA JR. MD
Anesthesiology
20201 CRAWFORD AVE
OLYMPIA FIELDS, IL 60461
Cook County (708) 503-3857
AISHA BAGGIA
Student in an Organized Health Care Education/Training Program
20201 CRAWFORD AVE
OLYMPIA FIELDS, IL 60461
Cook County (708) 747-4000

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 Jacob Kalliath's NPI number?

The NPI number for Jacob Kalliath is 1134569395. It was assigned to this individual provider in the NPPES registry on July 2, 2013.

Where is Jacob Kalliath located?

Jacob Kalliath practices at 20201 Crawford Ave, Olympia Fields, IL 60461. The listed phone number is (708) 679-2160.

What is Jacob Kalliath's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jacob Kalliath enrolled in Medicare?

Yes. Jacob Kalliath 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 organizations bill Medicare for Jacob Kalliath's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Kalliath reassigns Medicare benefits to 5 organizations: Swedish Covenant Management Services, Inc. (Chicago, IL), Light Matter Solutions LLC (Richland Center, WI), Rural Physicians Group-Pannu PLLC (Greenwood Village, CO), La Paz Regional Hospital, Inc. (Salome, AZ) and Chelan County Public Hospital District No 2 (Chelan, WA). Each 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 Jacob Kalliath's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Jacob Kalliath affiliated with any hospitals?

According to CMS data, Jacob Kalliath is affiliated with Lake Chelan Community Hospital.

When was this NPI record last updated?

The NPPES record for Jacob Kalliath was last updated on October 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.