NPIMap

Individual provider Active NPI

Adam Isaac Edelstein, MD

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Chicago, IL
National Provider Identifier
1013279082
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
036158132 Issued in IL
Practice address
259 E Erie St Ste 13-205
Chicago, IL 60611-2987
Phone
(312) 695-8143
Fax
(312) 695-4075
NPI assigned
Jun 14, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 69528 WI
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 2017004296 MO
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 036158132 IL Primary

Addresses

Primary practice location

259 E Erie St Ste 13-205
Chicago, IL 60611-2987

Mailing address

259 E Erie St Ste 13-205
Chicago, IL 60611-2987
Phone (312) 695-8143

Other practice location 1

N91W15750 Falls Pkwy
Menomonee Falls, WI 53051-2301
Phone (262) 532-1100

Other practice location 2

4921 Parkview Pl
Ste 6A/6B/12A
Saint Louis, MO 63110-1032
Phone (314) 747-2500

Other practice location 3

9200 W Wisconsin Ave
Milwaukee, WI 53226
Phone (414) 805-7410

Other identifiers 2

IdentifierTypeStateIssuer
1013279082MedicaidWI
1013279082MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180726001934 WI Practitioner - Orthopedic Surgery 2163726910 Reassigns benefits to 2 organizations
I20211112001466 IL Practitioner - Orthopedic Surgery 2163726910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Chicago, Pritzker School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

259 E Erie St
13TH Floor
Chicago, IL 60611-3926
Phone (312) 472-6036

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement40
Knee replacement64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69528WIMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jun 19, 2018 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Jul 1, 2018 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Nov 1, 2021 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Nov 1, 2021 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jun 19, 2018 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

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

259 E Erie St
Fl 13
Chicago, IL 60611

259 E Erie St
Ste 13205
Chicago, IL 60611

1704 Maple Ave
Ste 200
Evanston, IL 60201
Phone (847) 535-8500

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

N91W15750 Falls Pkwy
Menomonee Falls, WI 53051
Phone (262) 532-1100

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

Organizations & group practices 6

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 11

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": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1013279082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 13-205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112987",
            "telephone_number": "312-695-8143",
            "fax_number": "312-695-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 13-205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112987",
            "telephone_number": "312-695-8143",
            "fax_number": "312-695-4075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N91W15750 Falls Pkwy",
            "address_purpose": "LOCATION",
            "city": "Menomonee Falls",
            "state": "WI",
            "postal_code": "530512301",
            "country_code": "US",
            "telephone_number": "262-532-1100",
            "fax_number": "262-532-1409",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4921 Parkview Pl",
            "address_2": "Ste 6A/6B/12A",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101032",
            "country_code": "US",
            "telephone_number": "314-747-2500",
            "fax_number": "314-747-2598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "53226",
            "country_code": "US",
            "telephone_number": "414-805-7410",
            "fax_number": "414-805-7499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDELSTEIN",
        "first_name": "ADAM",
        "middle_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-14",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "WI",
            "license": "69528",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "MO",
            "license": "2017004296",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "IL",
            "license": "036158132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013279082",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013279082",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.