ETHAN JIN DO
NPI 1942051719
Anesthesiology - Addiction Medicine in Maywood, IL

Q: What is Ethan Jin's NPI number?

The NPI number for Ethan Jin is 1942051719. It was assigned to this individual provider in the NPPES registry on March 29, 2024.

Q: What is Ethan Jin's specialty?

The primary specialty registered for this NPI is Anesthesiology, specializing in Addiction Medicine, with taxonomy code 207LA0401X.

Q: When was this NPI record last updated?

The NPPES record for Ethan Jin was last updated on August 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since March 29, 2024PECOS Enrolled

2160 S 1ST AVE, MAYWOOD, IL 60153(708) 216-9169 Get Directions Write a Review

NPPES record last updated: August 13, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Ethan Jin Do NPPES

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

ETHAN JIN DO (NPI 1942051719) is an individual addiction medicine provider in Maywood, Illinois, licensed in Illinois (125.084194) and active in the NPI registry since March 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1942051719

Entity TypeIndividualMale

Primary Taxonomy207LA0401X

Provider Legal NameETHAN JINCredential: DO

Location Address2160 S 1ST AVEMaywood, IL 60153-3328

Mailing Address4145 Winterberry RdCumming, GA 30040-6167 · (770) 530-2870

Phone(708) 216-9169

Sole ProprietorNo

Enumeration DateMarch 29, 2024

Last NPPES UpdateAugust 13, 2024

NPPES CertifiedAugust 13, 2024

✔ NPI 1942051719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAnesthesiology · Addiction MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207LA0401X

License✔ Licensed in IL · 125.084194

Definition

An anesthesiologist who specializes in the diagnosis and treatment of addictions.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

2160 S 1ST AVE, Maywood, IL 60153

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethan Jin Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60153 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.

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.

ANITA OZA NAGAMINE M.D.

Radiology (Diagnostic Radiology)