Timothy S Petsche, M.D.

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

036101880 Issued in IL

Practice address

2525 Kaneville Rd
Geneva, IL 60134-2578

Phone

(630) 584-1400

Fax

(630) 584-1733

NPI assigned

Jan 30, 2006

Last updated

Dec 30, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Electronic endpoints 2

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

Specialty

Sports MedicineAlso: Orthopedic Surgery

Education

Michigan State University College of Human Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fox Valley Orthopaedic Associates, PLLCGroup PAC ID 6507830387, 73 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211
• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Merit-based Incentive Payment System (MIPS)

Final score

81.69 of 100Reported as group

Quality

74.66

Promoting interoperability

100

Improvement activities

40

Cost

64.3

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: timothy.petsche.1@26750.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.

• Fox Valley Orthopaedic Associates, PLLC

  • Orthopaedic Surgery Physician
  • Geneva, IL
  • NPI 1295706851
  Medicare reassignment Care Compare group NPD
• Fox Valley Orthopaedic Associates, PLLC

  dba Fox Valley Orthopaedic Ambulatory Surgical Center

  • Ambulatory Surgical Clinic/Center
  • Geneva, IL
  • NPI 1104897644
  NPD
• Fox Valley Orthopaedic Associates, S.C.

  • Orthopaedic Surgery Physician
  • Elgin, IL
  • NPI 1689212623
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation
• Delnor Community Hospital

  dba Northwestern Medicine Delnor Community Hospital

  • General Acute Care Hospital
  • Geneva, IL
  • NPI 1407859655
  Care Compare affiliation

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1124099809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 KANEVILLE RD",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342578",
            "telephone_number": "630-584-1400",
            "fax_number": "630-584-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 KANEVILLE RD",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342578",
            "telephone_number": "630-584-1400",
            "fax_number": "630-584-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETSCHE",
        "first_name": "TIMOTHY",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IL",
            "license": "036101880",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036-101880",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "200038329",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD GROUP",
            "identifier": "CF2064",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036101880",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "753210",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tpetsche282006@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2525 Kaneville Rd",
            "city": "Geneva",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601342578",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2525 Kaneville Rd",
            "city": "Geneva",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601342578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Performance Spine & Sport LLC
• Performance Spine and Sport Holdings LLC
• Joseph M Persak, M.D.
• Jennifer Lynn Peterson, APRN
• Jasper A Petrucci, M.D.
• Mark J Pettinger, RPH
• Tegan Pfortmiller
• Candace Martin Phelan, LCPC
• Binu Philip, M.D.
• Tikayla Phillips, CADC

• Sports Medicine (Orthopaedic Surgery) Physician in Geneva, IL
• Providers in Geneva, IL by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.