Nicolas S Anderson, DPM
Individual provider Active NPI Foot & Ankle Surgery Podiatrist · Riverside, IL
NPI 1124179817 · NPPES record last updated Jun 6, 2012
Key facts
- NPI
- 1124179817
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- 016-005287 (IL)
- Practice address
- 353 E Burlington St
Suite 100
Riverside, IL 60546-2189 - Phone
- (708) 442-0221
- Fax
- (708) 442-5670
- NPI assigned
- Jan 16, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Podiatry
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Midland Orthopedic Associates PLLC
Practice addresses (Care Compare)
2850 S Wabash Ave
Suite 100
Chicago, IL 60616-2491
Phone (312) 842-4600
Hospital & facility affiliations
- Uchicago Medicine Adventhealth la Grange
- Macneal Hospital
- Uchicago Medicine Adventhealth Hinsdale
- Loyola University Medical Center
- Uchicago Medicine Adventhealth Bolingbrook
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 762 |
| Removal of skin lesions | 43 |
| Removal of nail tissue | 731 |
| Removal or shaving of skin growth | 327 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080923000418 | IL | Practitioner - Podiatry | 8729155460 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016-005287 | IL | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midland Orthopedic Associates PLLC | Current |
Accepting new patients |
Locations
2850 S Wabash Ave
Ste 100
Chicago, IL 60616
Phone (312) 842-4600
353 E Burlington St
Ste 100
Riverside, IL 60546
Phone (708) 324-6641
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 016-005287 | IL | Yes |
Addresses
Primary practice location
353 E Burlington St
Suite 100
Riverside, IL 60546-2189
Mailing address
353 E Burlington Street
Suite 100
Riverside, IL 60546
Phone (708) 442-0221
Other providers in Riverside, IL
- Adventist Health Partners,Inc
- Cassandra Kay Albert
- Vilija Aleksa
- Alikhan Nadira MD
- Dawne R Anderson
- Marie Apke
- Molly Ann Bridget Arnold
- Athletico LTD.
- Kai Avegno-Ross
- Berwyn Community Pharmacy
All providers in Riverside, IL · Foot & Ankle Surgery Podiatrist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.