Official registry information on file with the National Plan and Provider Enumeration System.
ERIK DAVID ENGLEHART M.D. (NPI 1679581367) is an individual family medicine provider in Sandwich, Illinois, licensed in Illinois (036-107672) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Katherine Shaw Bethea Hospital, and is a graduate of Other (2003).
NPPES Registry Identity
NPI1679581367
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameERIK DAVID ENGLEHARTCredential: M.D.
Location Address1310 N MAIN ST STE 200Sandwich, IL 60548-1397
Mailing Address1310 N Main St Ste 200Sandwich, IL 60548-1397 · (815) 786-7150 · Fax (815) 786-3785
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
✔
Enrolled in Medicare and accepts Medicare assignment
Erik David Englehart M.d. 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 ID7214832716
PECOS Enrollment IDI20031205000642
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.
Areas of Expertise CMS Part B claims22
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 nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
1,555 services408 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
724 services186 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
335 services203 patients
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
287 services264 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
160 services153 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
145 services104 patients
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180
This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
137 services116 patients
Anticoagulant management of patient taking warfarin 93793
Anticoagulant management with warfarin involves monitoring and adjusting your medication to prevent blood clots while minimizing the risk of bleeding. Regular blood tests measure your response to warfarin, helping adjust your dose if necessary. It's crucial to maintain a consistent diet and promptly report any changes in your health.
125 services18 patients
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
119 services110 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
114 services114 patients
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a G0179
This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.
105 services54 patients
Blood test, clotting time 85610
A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.
89 services13 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
80 services20 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
74 services71 patients
Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348
An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.
74 services34 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
68 services47 patients
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg J3420
This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.
40 services12 patients
Telephone medical discussion with physician, 11-20 minutes 99442
This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
24 services19 patients
Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99304
An initial nursing facility visit is a daily check-up to monitor your health status. This service, lasting typically 25 minutes, involves a nurse assessing your overall wellbeing, discussing concerns, and updating your care plan as needed.
20 services20 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
13 services13 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
13 services13 patients
Hospital Affiliations CMS Care Compare5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Location1301 North Main StreetSandwich, IL 60548 · De Kalb County
✓ Emergency services
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 60548 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42(range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31(range $4.29 – $34.14)
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.
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.
94.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality
82.59
Promoting Interoperability
100
Improvement Activities
40
Referred Medical Equipment & Supplies CMS DME claims40
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
11 suppliers48 claims192 services$6.65 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
3 suppliers13 claims13 services$2.94 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers21 claims49 services$1.14 avg. paid by Medicare
Insertion tray without drainage bag and without catheter (accessories only) A4310
DME-Medical/Surgical Supplies · category DA000N
1 supplier11 claims11 services$7.43 avg. paid by Medicare
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4338
DME-Orthotic Devices · category DF000N
1 supplier11 claims11 services$11.80 avg. paid by Medicare
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357
DME-Orthotic Devices · category DF000N
5 suppliers24 claims43 services$8.70 avg. paid by Medicare
Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each A4373
DME-Orthotic Devices · category DF010N
2 suppliers13 claims270 services$5.61 avg. paid by Medicare
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each A4409
DME-Orthotic Devices · category DF010N
1 supplier13 claims230 services$5.84 avg. paid by Medicare
Tape, non-waterproof, per 18 square inches A4450
DME-Medical/Surgical Supplies · category DA000N
2 suppliers11 claims620 services$0.08 avg. paid by Medicare
Tape, waterproof, per 18 square inches A4452
DME-Medical/Surgical Supplies · category DA000N
3 suppliers13 claims2,042 services$0.36 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
4 suppliers19 claims19 services$36.67 avg. paid by Medicare
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each A5063
DME-Orthotic Devices · category DF010N
3 suppliers20 claims490 services$2.58 avg. paid by Medicare
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe A5500
DME-Orthotic Devices · category DF000N
2 suppliers16 claims32 services$61.12 avg. paid by Medicare
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each A5512
DME-Orthotic Devices · category DF000N
1 supplier15 claims90 services$24.91 avg. paid by Medicare
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6212
DME-Medical/Surgical Supplies · category DA023N
2 suppliers16 claims180 services$9.34 avg. paid by Medicare
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing A6252
DME-Medical/Surgical Supplies · category DA023N
2 suppliers11 claims404 services$3.13 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
5 suppliers17 claims17 services$81.26 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
5 suppliers17 claims46 services$31.13 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
3 suppliers15 claims15 services$48.60 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
6 suppliers18 claims18 services$19.30 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
6 suppliers32 claims180 services$2.18 avg. paid by Medicare
Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046
DME-Other DME · category DE001N
5 suppliers14 claims14 services$10.79 avg. paid by Medicare
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
2 suppliers19 claims570 services$6.39 avg. paid by Medicare
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4150
Other-Enteral and Parenteral · category OB006N
1 supplier11 claims5,508 services$0.37 avg. paid by Medicare
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152
Other-Enteral and Parenteral · category OB006N
2 suppliers19 claims9,472 services$0.27 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
4 suppliers30 claims32 services$48.74 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
5 suppliers45 claims47 services$16.56 avg. paid by Medicare
Humidifier, heated, used with positive airway pressure device E0562
DME-Other DME · category DE001N
2 suppliers16 claims16 services$18.78 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers29 claims30 services$4.92 avg. paid by Medicare
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Erik Englehart's NPI number?
The NPI number for Erik Englehart is 1679581367. It was assigned to this individual provider in the NPPES registry on August 4, 2006.
Where is Erik Englehart located?
Erik Englehart practices at 1310 N Main St Ste 200, Sandwich, IL 60548. The listed phone number is (815) 786-7150.
What is Erik Englehart's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Erik Englehart enrolled in Medicare?
Yes. Erik Englehart 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.
Is Erik Englehart affiliated with any hospitals?
According to CMS data, Erik Englehart is affiliated with Katherine Shaw Bethea Hospital, Northwestern Medicine Central Dupage Hospital, Northwestern Medicine Kishwaukee Hospital, Rochelle Community Hospital and Valley West Community Hospital.
When was this NPI record last updated?
The NPPES record for Erik Englehart was last updated on March 27, 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.
# Erik David Englehart, M.D. · NPI 1679581367
Family Medicine physician in Sandwich, Illinois. Individual provider, active in the CMS NPPES registry since August 4, 2006.
## Identity
- **NPI:** 1679581367 (Entity type: Individual)
- **Enumerated:** August 4, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 036-107672 (Illinois)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1310 N MAIN ST STE 200, Sandwich, IL 60548-1397
- **Phone:** (815) 786-7150 · **Fax:** (815) 786-3785
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2003
## Record status
- **NPPES last updated:** March 27, 2020
- **Other identifiers:** Medicaid 036-107672 (IL); Other 80-0101372 (IL); Other 1932033 (IL); and 6 more
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Source: [NPI Profile](https://npiprofile.com/npi/1679581367) · Data from the CMS NPPES public registry.
