POOME CHAMNANKIT (APN-CNP) – Nurse Practitioner, NPI 1417168022
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
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Provider Addresses for POOME CHAMNANKIT (APN-CNP)
Ridge Avenue, Evanston, Evanston Township, Cook County, Illinois, 60645, United States
EVANSTON, IL 602011700
Phone: (847) 570-2332
Fax: (847) 570-1436
Type: Mailing
Evanston Hospital, 2650, Ridge Avenue, Evanston, Evanston Township, Cook County, Illinois, 60201, United States
ICU, RM 3935A
EVANSTON, IL 602011718
Phone: (847) 570-2428
Fax: (847) 570-1436
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $183.
Total Amount is formed as General ($183) + Research ($0) + Ownership ($0) = $183.
Last reported payment date: 2024-10-15 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($132).
Total Amount
$183
General + Research + Ownership
Payments
3
Total payment records
General Amount
$183
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| E.R. Squibb & Sons, L.L.C. | $132 |
| ABIOMED | $27 |
| Novo Nordisk Inc | $24 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-05-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200526000941 | I | Nurse Practitioner | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60201)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| E N D O C R I N O L O G Y | IL | |
| N E U R O L O G Y | IL | |
| Hospitalist, Internal Medicine | IL | |
| O P H T H A L M O L O G Y | IL | |
| - | IL | |
| E N D O C R I N O L O G Y | IL | |
| Diagnostic Radiology | IL | |
| Family Practice | IL | |
| - | IL |
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