NPIMap

Individual provider Active NPI

Nicholas J Zoretic, DO

  • Family Medicine Physician
  • Bloomingdale, IL
National Provider Identifier
1003820820
Registry record updated May 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036107388 Issued in IL
Practice address
245 S Gary Ave
Suite 100
Bloomingdale, IL 60108-2200
Phone
(630) 924-4009
Fax
(630) 924-9671
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036107388 IL Primary

Addresses

Primary practice location

245 S Gary Ave
Suite 100
Bloomingdale, IL 60108-2200

Mailing address

245 S Gary Ave
Suite 100
Bloomingdale, IL 60108-2200
Phone (630) 924-4009

Other identifiers 4

IdentifierTypeStateIssuer
3631498336019001OtherILCDPG HFS PAYEE ID
363149833OtherILTAX IDENTIFICATION NUMBER
0222075OtherILBLUE CROSS GROUP NUMBER
036107388MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101020000260 IL Practitioner - Family Practice 9638362890 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

245 S Gary Ave
Suite 100
Bloomingdale, IL 60108-2200
Phone (630) 924-4009

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036107388ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Hospital Association CurrentSince Jun 19, 2003 Accepting new patients
Central Dupage Physician Group Family Medicine CurrentSince Jan 1, 2007 Accepting new patients
Winfield Pathology Consultants, S.C. Current Accepting new patients
Central Dupage Physician Group CurrentSince Jan 1, 2007 Accepting new patients
Central Dupage Hospital Association CurrentSince Jun 19, 2003 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Roy J. Betti, M.D.S.C. Past Accepting new patients

Locations

233 S Gary Ave
Bloomingdale, IL 60108
Phone (630) 208-6775

245 S Gary Ave
Ste 100
Bloomingdale, IL 60108
Phone (630) 924-4009

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

300 Randall Rd
Geneva, IL 60134
Phone (630) 208-4009

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

0N025 Winfield Rd
Winfield, IL 60190
Phone (630) 832-0050

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336953600000",
    "number": "1003820820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 S GARY AVE",
            "address_2": "SUITE 100",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082200",
            "telephone_number": "630-924-4009",
            "fax_number": "630-924-9671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 S GARY AVE",
            "address_2": "SUITE 100",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082200",
            "telephone_number": "630-924-4009",
            "fax_number": "630-924-9671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZORETIC",
        "first_name": "NICHOLAS",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2012-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036107388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPG HFS PAYEE ID",
            "identifier": "3631498336019001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "363149833",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP NUMBER",
            "identifier": "0222075",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036107388",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

Verify at the official NPI Registry.