Individual provider Active NPI

Robert J Sheffey, DPM

  • Foot & Ankle Surgery Podiatrist
  • Chicago, IL
National Provider Identifier
1063417830
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016-005133 Issued in IL
Practice address
3260 W 111TH St
Chicago, IL 60655
Phone
(773) 239-0702
Fax
(773) 239-0712
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 016-005133 IL Primary

Addresses

Primary practice location

3260 W 111TH St
Chicago, IL 60655

Mailing address

3260 W 111TH St
Chicago, IL 60655-2205
Phone (773) 239-0702

Other identifiers 6

IdentifierTypeStateIssuer
0001636066OtherILBCBS
016005133MedicaidIL
P00260559OtherILRAILROAD MEDICARE
P00390803OtherILRAILROAD MEDICARE
0001621735OtherILBCBS
131370500OtherILDEPT OF LABOR

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050309000519 IL Practitioner - Podiatry 5496709735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chicagoland Foot and Ankle, PCGroup PAC ID 9931116225, 7 clinicians

Practice addresses (Care Compare)

3260 W 111TH St
Chicago, IL 60655-2729
Phone (773) 239-0702

8145 N Milwaukee Ave
Niles, IL 60714-2828
Phone (773) 239-0702

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue27
Removal of nail tissue72
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016-005133ILMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Chicagoland Foot and Ankle, PC Foot & Ankle Surgery CurrentSince Feb 1, 2006 Accepting new patients
Chicagoland Foot and Ankle, PC Foot & Ankle Surgery Current Accepting new patients
Chicagoland Foot and Ankle, PC Foot & Ankle Surgery CurrentSince Feb 1, 2006 Accepting new patients
Advanced Surgical Specialists Inc Foot & Ankle Surgery Past Accepting new patients
Chicagoland Foot and Ankle, PC Past Accepting new patients
Nikola Ivancevic DPM PC Past Accepting new patients
Jondelle Jenkins Foot & Ankle Surgery Past Accepting new patients
Chicagoland Foot and Ankle PC Past Accepting new patients
Thomas Valente M.D., P.a. Past Accepting new patients

Locations

1938 E Lincoln Hwy
Ste 206
New Lenox, IL 60451
Phone (815) 462-9225

Interoperability endpoints

  • Direct secure messaging: robert.sheffey@cfaa-il.direct.office.nextgen.com

Organizations & group practices 11

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

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1063417830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 W 111TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606552205",
            "telephone_number": "773-239-0702",
            "fax_number": "773-239-0712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 W 111TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60655",
            "telephone_number": "773-239-0702",
            "fax_number": "773-239-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEFFEY",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016-005133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0001636066",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016005133",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00260559",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00390803",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0001621735",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "131370500",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.