Individual provider Active NPI

Craig Thomas Cortese, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Normal, IL
National Provider Identifier
1124030192
Registry record updated Apr 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016-005065 Issued in IL
Practice address
1607 Visa Dr Ste 5B
Normal, IL 61761-6160
Phone
(309) 452-3000
Fax
(309) 452-3668
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2011

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 016-005065 IL Primary

Addresses

Primary practice location

1607 Visa Dr Ste 5B
Normal, IL 61761-6160

Mailing address

1607 Visa Dr Ste 5B
Normal, IL 61761-6160
Phone (309) 452-3000

Other identifiers 1

IdentifierTypeStateIssuer
016005065MedicaidIL

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
I20040702000751 IL Practitioner - Podiatry 8123005592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cortese Foot and Ankle Clinic PCGroup PAC ID 9739166109, 4 clinicians

Practice addresses (Care Compare)

1607 Visa Dr
Suite 5B
Normal, IL 61761-6160
Phone (309) 452-3000

Hospital & facility affiliations

  • St Joseph Medical Center Hospital, Bloomington, IL, CCN 140162
  • Carle Bromenn Medical Center Hospital, Normal, IL, CCN 140127

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue134
Removal of skin lesions1-10
Removal of nail tissue387
Removal or shaving of skin growth178
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016-005065ILMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Cortese Foot and Ankle Clinic, P.C. Foot & Ankle Surgery CurrentSince Jul 1, 2004 Accepting new patients

Locations

1607 Visa Dr
Ste 5B
Normal, IL 61761
Phone (309) 452-3000

Organizations & group practices 1

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302220800000",
    "number": "1124030192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 VISA DR STE 5B",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616160",
            "telephone_number": "309-452-3000",
            "fax_number": "309-452-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 VISA DR STE 5B",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616160",
            "telephone_number": "309-452-3000",
            "fax_number": "309-452-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORTESE",
        "first_name": "CRAIG",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2011-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016-005065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016005065",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

Verify at the official NPI Registry.