Individual provider Active NPI

Gerard Geurts, PA-C

  • Physician Assistant
  • Wheaton, IL
National Provider Identifier
1225010119
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085001584 Issued in IL
Practice address
7 Blanchard Cir
Wheaton, IL 60189-2037
Phone
(630) 926-4337
Fax
(630) 653-0988
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085001584 IL Primary

Addresses

Primary practice location

7 Blanchard Cir
Wheaton, IL 60189-2037

Mailing address

7 Blanchard Cir
Wheaton, IL 60189-2037
Phone (630) 653-0848

Other identifiers 5

IdentifierTypeStateIssuer
550894537OtherILTAX ID
920540OtherILMEDICARE PTAN (GROUP)
K03094OtherMCR
F400104135OtherILMEDICARE PTAN (INDIVIDUAL)
K18826OtherMCR ID

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040311001004 IL Practitioner - Physician Assistant 2769371475 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

2490 Bushwood Dr
Elgin, IL 60124-7898
Phone (224) 293-5200

3475 S Alpine Rd
Rockford, IL 61109-2604
Phone (815) 874-8000

405 W Golf Rd
Schaumburg, IL 60195-3501
Phone (224) 215-0011

4211 N Cicero Ave
Chicago, IL 60641-1651
Phone (773) 794-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Apr 1, 2004 Accepting new patients

Locations

300 Randall Rd
Geneva, IL 60134
Phone (630) 208-4009

7 Blanchard Cir
Wheaton, IL 60189
Phone (630) 510-9009

2180 Manchester Rd
Wheaton, IL 60187
Phone (630) 665-4330

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1225010119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BLANCHARD CIR",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601892037",
            "telephone_number": "630-653-0848",
            "fax_number": "630-653-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 BLANCHARD CIR",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601892037",
            "telephone_number": "630-926-4337",
            "fax_number": "630-653-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEURTS",
        "first_name": "GERARD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "550894537",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (GROUP)",
            "identifier": "920540",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR",
            "identifier": "K03094",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "F400104135",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCR ID",
            "identifier": "K18826",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.