Charles G Groen, MD is a medicare enrolled "Radiology - Radiation Oncology" physician in Niles, Illinois. His current practice location is
8915 W Golf Rd, 3rd Floor, Niles, Illinois. You can reach out to his office (for appointments etc.) via phone at
(847) 827-9490.
Charles G Groen is licensed to practice in Indiana (license number 01068054A) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1497742860.
Physician's Profile
Full Name | Charles G Groen |
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Gender | Male |
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Speciality | Radiology - Radiation Oncology |
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Location | 8915 W Golf Rd, Niles, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1497742860
- Provider Enumeration Date: 09/30/2005
- Last Update Date: 11/04/2011
Medicare PECOS Information:
- PECOS PAC ID: 1254231426
- Enrollment ID: I20110907001390
Medical Identifiers
Medical identifiers for Charles G Groen such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1497742860 | NPI | - | NPPES |
000000726585 | Other | IN | ANTHEM PROVIDER NUMBER |
036085244 | Medicaid | IL | |
201034800 | Medicaid | IN | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2085R0001X | Radiology - Radiation Oncology | 036085244 (Illinois) | Secondary |
2085R0001X | Radiology - Radiation Oncology | 01068054A (Indiana) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Charles G Groen allows following entities to bill medicare on his behalf.
Entity Name | Ludag Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1336195353 PECOS PAC ID: 3779516703 Enrollment ID: O20050912000405 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Charles G Groen is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Charles G Groen, MD 3610 Paysphere Cir, Chicago, IL 60674-0036 Ph: (847) 585-7000 | Charles G Groen, MD 8915 W Golf Rd, 3rd Floor, Niles, IL 60714-5905 Ph: (847) 827-9490 |
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