Individual provider Active NPI

Grigory E Gershkovich, M.D.

  • Orthopaedic Hand Surgery Physician
  • Chicago, IL
National Provider Identifier
1235491069
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
C1-0024073 Issued in DE
Practice address
5841 S Maryland Ave # Mc3079
Chicago, IL 60637-1447
Phone
(773) 834-1634
Fax
(773) 702-4384
NPI assigned
Jun 7, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X C1-0024073 DE
Orthopaedic Hand Surgery Physician 207XS0106X 125069742 IL
Orthopaedic Hand Surgery Physician 207XS0106X C1-0024073 DE Primary

Addresses

Primary practice location

5841 S Maryland Ave # Mc3079
Chicago, IL 60637-1447

Mailing address

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone (773) 702-1150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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

Enrollment IDStateProvider typePAC IDDetails
I20210610001497 DE Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 0244502631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hand SurgeryAlso: Orthopedic Surgery
Education
Georgetown University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First State Orthopaedics PAGroup PAC ID 6103800057, 97 clinicians

Practice addresses (Care Compare)

4745 Ogletown Stanton Rd
Suite 225
Newark, DE 19713-1340
Phone (302) 731-2888

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.8 of 100Reported as group
Quality
96
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C1-0024073DEMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First State Orthopaedics, PA Orthopaedic Surgery CurrentSince Jul 1, 2021 Accepting new patients
First State Orthopaedics PA Orthopaedic Surgery Current Accepting new patients
First State Orthopaedics PA CurrentSince Jul 1, 2021 Accepting new patients

Locations

285 Beiser Blvd
Ste 201
Dover, DE 19904

601 Tower Ln
Ste 201
Middletown, DE 19709

4745 Stanton Ogletown Rd
Ste 225
Newark, DE 19713
Phone 30273128881001

4745 Ogletown Stanton Rd
Ste 238
Newark, DE 19713

211 Executive Dr
Ste 11
Newark, DE 19702
Phone (302) 793-1800

100 S Main St
Ste 300
Smyrna, DE 19977
Phone (302) 389-7855

1401 Foulk Rd
Ste 101
Wilmington, DE 19803
Phone (302) 478-5500

Interoperability endpoints

  • Direct secure messaging: grigory.gershkovichmd.p1@direct.fsoortho.nextgenshare.com

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.

Hospital & facility affiliations 3

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": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1235491069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686",
            "telephone_number": "773-702-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE # MC3079",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447",
            "telephone_number": "773-834-1634",
            "fax_number": "773-702-4384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSHKOVICH",
        "first_name": "GRIGORY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-07",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "DE",
            "license": "C1-0024073",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "IL",
            "license": "125069742",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "DE",
            "license": "C1-0024073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.