Mary Kathleen Walsh, PA-C

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

085007391 Issued in IL

Practice address

1611 W Harrison St
Chicago, IL 60612-4861

Phone

(877) 632-6637

NPI assigned

Jan 5, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, IN2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthomidwest, PLLCGroup PAC ID 0749183713, 531 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rush Oak Park Hospital Hospital, Oak Park, IL, CCN 140063

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.kate.walsh.1@12576.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 and National Provider Directory roles.

• Orthomidwest, PLLC

  • Orthopaedic Surgery Physician
  • Rockford, IL
  • NPI 1730136474

  IN, Sports Medicine

  Medicare reassignment Care Compare group NPD
• Midwest Orthopaedics at Rush, LLC

  • Orthopaedic Surgery Physician
  • Chicago, IL
  • NPI 1811942451

  IN

  Medicare reassignment NPD
• Midwest Orthopaedics at Rush LLC

  • Durable Medical Equipment & Medical Supplies
  • Orland Park, IL
  • NPI 1134871908
  NPD
• Orthomidwest, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Buffalo Grove, IL
  • NPI 1043180839
  NPD

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

• Rush Oak Park Hospital Inc

  • General Acute Care Hospital
  • Oak Park, IL
  • NPI 1558391706
  Care Compare affiliation

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

{
    "created_epoch": "1578182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578182400000",
    "number": "1225677404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 WILLIAM DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463858182",
            "telephone_number": "219-246-7981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "877-632-6637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-05",
        "last_updated": "2020-01-05",
        "certification_date": "2020-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IL",
            "license": "085007391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda J Walsh
• Macey R Walsh
• Madeleine Kathleen Walsh
• Madelline Walsh
• Mary E Walsh
• Megan Walsh, MA, CCC-SLP
• Monica Walsh, LCSW
• Morgan Walsh, OTR/L, CLT
• Nancy Ann Walsh
• Nicholas Tyler Walsh, PA-C

• Sports Medicine (Orthopaedic Surgery) Physician in Chicago, IL
• Providers in Chicago, 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 Jan 5, 2020; 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.