Douglas Joseph Pacaccio, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016005351 Issued in IL

Practice address

5875 E Riverside Blvd
Rockford, IL 61114-4937

Phone

(815) 398-9491

Fax

(815) 381-7498

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthomidwest, PLLCGroup PAC ID 0749183713, 531 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233
• Northwestern Medicine Kishwaukee Hospital Hospital, Dekalb, IL, CCN 140286

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• IL HMO C-SNP
• devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
• devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
• IL PPO Downstate
• devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc

Interoperability endpoints

• Direct secure messaging: douglas.pacaccio@ro.eclinicaldirectplus.com

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.

• Orthomidwest, PLLC

  • Orthopaedic Surgery Physician
  • Rockford, IL
  • NPI 1730136474

  Podiatrist, WI

  Medicare reassignment Care Compare group NPD
• Northern Illinois Foot & Ankle Specialists, LTD

  • Foot & Ankle Surgery Podiatrist
  • Crystal Lake, IL
  • NPI 1851702302
  Medicare reassignment NPD
• Northern Illinois Foot & Ankle Specialists, LTD

  • Foot & Ankle Surgery Podiatrist
  • Elgin, IL
  • NPI 1285267328
  NPD
• Northern Illinois Foot & Ankle Specialists, LTD

  • Podiatric Clinic/Center
  • Bloomingdale, IL
  • NPI 1427854215

  Podiatrist

  NPD
• Orthomidwest, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Buffalo Grove, IL
  • NPI 1043180839
  NPD

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

• Kishwaukee Community Hospital

  • General Acute Care Hospital
  • Dekalb, IL
  • NPI 1669534517
  Care Compare affiliation
• Saint Anthony Medical Center

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1790739977
  Care Compare affiliation

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1013005867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5875 E RIVERSIDE BLVD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611144937",
            "telephone_number": "815-398-9491",
            "fax_number": "815-381-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 E RIVERSIDE BLVD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611144937",
            "telephone_number": "815-398-9491",
            "fax_number": "815-381-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACACCIO",
        "first_name": "DOUGLAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016005351",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "2006022045",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016005351",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark A Oyer, MD
• Donna Jean Oyston, NP
• Erin Margaret Ozminkowski
• PA Peterson at the Citadel LLC
• PA Peterson LLC
• Adriana Carolina Padron, DMD
• Andrea Padron, BSN
• Ixchel Pagan, LMT
• Pain Centers of Chicago LLC
• Pain Management Associates, LTD

• Foot & Ankle Surgery Podiatrist in Rockford, IL
• Providers in Rockford, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.