Individual provider Active NPI

Howard Clark Federer III, M.D.

  • Surgery Physician
  • Chicago, IL
National Provider Identifier
1023039674
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036072388 Issued in IL
Practice address
2740 W Foster Ave
Suite 213
Chicago, IL 60625-3500
Phone
(773) 293-4001
Fax
(773) 293-3203
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036072388 IL Primary

Addresses

Primary practice location

2740 W Foster Ave
Suite 213
Chicago, IL 60625-3500

Mailing address

2740 W Foster Ave Ste 213
Chicago, IL 60625-3532
Phone (773) 293-4001

Other identifiers 2

IdentifierTypeStateIssuer
036-072388MedicaidIL
406120103OtherPTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hfederer277130@direct.northshore.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110211000177 IL Practitioner - General Surgery 8224218037 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Texas Tech University Health Science Center School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

2739 W Foster Ave
Chicago, IL 60625-3661
Phone (773) 878-8200

5140 N California
Suite G600
Chicago, IL 60625-3645
Phone (773) 989-3803

5140 N California Ave
Chicago, IL 60625-2577

5140 N California Ave
Chicago, IL 60625-3645

5145 N California
Hosps Suite 331
Chicago, IL 60625-3661
Phone (847) 570-2280

5145 N California Ave
Chicago, IL 60625-3661
Phone (773) 878-8200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036072388ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Mar 2, 2021 Accepting new patients
Swedish Covenant Management Services, Inc CurrentSince Apr 28, 2013 Accepting new patients
Swedish Covenant Management Services, Inc. CurrentSince Apr 28, 2013 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients

Locations

5140 N California Ave
Chicago, IL 60625
Phone (773) 275-8811

9532 Eagle Way
Chicago, IL 60678

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

2740 W Foster Ave
Ste LL7
Chicago, IL 60625

2740 W Foster Ave
Ste 213
Chicago, IL 60625
Phone (773) 293-4001

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

Interoperability endpoints

  • Direct secure messaging: hfederer277130@direct.northshore.org

Organizations & group practices 4

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 2

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1023039674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE STE 213",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253532",
            "telephone_number": "773-293-4001",
            "fax_number": "773-293-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE",
            "address_2": "SUITE 213",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253500",
            "telephone_number": "773-293-4001",
            "fax_number": "773-293-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDERER",
        "first_name": "HOWARD",
        "middle_name": "CLARK",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036072388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-072388",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "406120103",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hfederer277130@direct.northshore.org",
            "affiliation": "N",
            "address_1": "2740 W Foster Ave",
            "address_2": "Suite 213",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606253500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.