NPIMap

Individual provider Active NPI

Susan E Marcotte, D.O.

  • Family Medicine Physician
  • Orland Park, IL
National Provider Identifier
1184678377
Registry record updated May 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036075405 Issued in IL
Practice address
16527 106TH CT
Orland Park, IL 60467-4545
Phone
(708) 675-1070
Fax
(708) 675-1073
NPI assigned
May 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036075405 IL Primary

Addresses

Primary practice location

16527 106TH CT
Orland Park, IL 60467-4545

Mailing address

16527 106TH CT
Orland Park, IL 60467-4545
Phone (708) 675-1070

Other identifiers 1

IdentifierTypeStateIssuer
036075405MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100524000925 IL Practitioner - Family Practice 4789658899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Health Associates PCGroup PAC ID 0749254845, 9 clinicians

Practice addresses (Care Compare)

10300 Village Circle Dr
Palos Park, IL 60464-3541
Phone (708) 361-6091

16512 S 106TH CT
Orlando Park, IL 60467-4547
Phone (708) 364-8323

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Health Associates PC Family Medicine CurrentSince Jan 1, 1998 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

16527 106th Ct
Orland Park, IL 60467
Phone (708) 675-1070

16512 106th Ct
Orland Park, IL 60467
Phone (708) 364-8323

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JGEBDA
  • FHIR API: https://fhir4.healow.com/fhir/r4/JGEBDA/Endpoint/JGEBDA
  • Direct secure messaging: susan.marcotte@pha16512.eclinicaldirectplus.com

Organizations & group practices 2

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 11

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337299200000",
    "number": "1184678377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16527 106TH CT",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604674545",
            "telephone_number": "708-675-1070",
            "fax_number": "708-675-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16527 106TH CT",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604674545",
            "telephone_number": "708-675-1070",
            "fax_number": "708-675-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCOTTE",
        "first_name": "SUSAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2012-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036075405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036075405",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.