Peter Misurec, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

036-061571 Issued in IL

Practice address

3340 Oak Park Ave
Suite 305
Berwyn, IL 60402-3420

Phone

(708) 484-6019

Fax

(708) 484-0251

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: peter.misurec.1@3164.direct.athenahealth.com

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.

• Suburban Urology Associates,LTD

  • Specialist
  • Berwyn, IL
  • NPI 1366626996
  Authorized official Same address or phone

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1114087962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 OAK PARK AVE",
            "address_2": "SUITE 305",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023420",
            "telephone_number": "708-484-6019",
            "fax_number": "708-484-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 OAK PARK AVE",
            "address_2": "SUITE 305",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023420",
            "telephone_number": "708-484-6019",
            "fax_number": "708-484-0251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISUREC",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036-061571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036061571",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dajuan Miller, M.A QMHP
• Kenneth R Miller, DC
• Mindful Wellness LLC
• Debra Ann Mirabelli, MED
• Virginia Mireles
• Leah Mercedes Mizell, LCSW
• MN Anesthesia LLC
• Farah Parveen Mohammed, DPM
• Reema Mohammed, M.D.
• Mehwish Moktader, DO

• Urology Physician in Berwyn, IL
• Providers in Berwyn, IL by specialty
• Urology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.