Individual provider Active NPI

Thomas A Wiedrich, MD

  • Orthopaedic Hand Surgery Physician
  • Chicago, IL
National Provider Identifier
1124080189
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
36074824 Issued in IL
Practice address
737 N Michigan Ave
Ste 700
Chicago, IL 60611-6662
Phone
(312) 337-6960
Fax
(312) 337-3601
NPI assigned
Apr 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X 36074824 IL Primary

Addresses

Primary practice location

737 N Michigan Ave
Ste 700
Chicago, IL 60611-6662

Mailing address

737 N Michigan Ave
Ste 700
Chicago, IL 60611-6662
Phone (312) 337-6960

Other identifiers 1

IdentifierTypeStateIssuer
036074824MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36074824ILMDOrthopaedic Hand Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1124080189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 N MICHIGAN AVE",
            "address_2": "STE 700",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606116662",
            "telephone_number": "312-337-6960",
            "fax_number": "312-337-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 N MICHIGAN AVE",
            "address_2": "STE 700",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606116662",
            "telephone_number": "312-337-6960",
            "fax_number": "312-337-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDRICH",
        "first_name": "THOMAS",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "IL",
            "license": "36074824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036074824",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.