Individual provider Active NPI

Mark G Neerhof, DO

  • Maternal & Fetal Medicine Physician
  • Kenosha, WI
National Provider Identifier
1255359675
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
036071277 Issued in IL
Practice address
10400 75TH St
Kenosha, WI 53142-7884
Phone
(262) 948-7000
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 036071277 IL Primary
Obstetrics & Gynecology Physician 207V00000X 81-321 WI
Maternal & Fetal Medicine Physician 207VM0101X EMC0003938 MI

Addresses

Primary practice location

10400 75TH St
Kenosha, WI 53142-7884

Mailing address

10400 75TH St
Kenosha, WI 53142-7884
Phone (262) 948-7000

Other practice location 1

2650 Ridge Ave
Walgreen Building Suite 1507
Evanston, IL 60201-1718
Phone (847) 570-2280

Other practice location 2

601 John St Ste N1100
Kalamazoo, MI 49007-5349
Phone (269) 341-7887

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address mneerhof5523@direct.northshore.org
Direct Messaging Address mneerhof5523@direct.northshore.org
Direct Messaging Address direct@direct.bronsonhg.org Direct Bronson HealthCare Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040624000317 IL Practitioner - Obstetrics/Gynecology 7517942386 Reassigns benefits to 2 organizations
I20240703001255 MI Practitioner - Obstetrics/Gynecology 7517942386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
81-321WIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Apr 9, 2001 Accepting new patients
Endeavor Health Medical Group Obstetrics & Gynecology CurrentSince Apr 9, 2001 Accepting new patients
Bronson Methodist Hospital Obstetrics & Gynecology CurrentSince Jul 15, 2024 Accepting new patients
Swedish Covenant Management Services, Inc CurrentSince Mar 15, 2020 Accepting new patients
Swedish Covenant Management Services, Inc. Obstetrics & Gynecology Current Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 1507
Evanston, IL 60201
Phone (847) 570-2860

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

15 Tower Ct
Ste 300
Gurnee, IL 60031
Phone (847) 599-3600

757 Park Ave W
Ste 3870
Highland Park, IL 60035
Phone (847) 926-6544

890 Garfield Ave
Ste 202
Libertyville, IL 60048
Phone (847) 318-9330

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

601 John St
Ste N1100
Kalamazoo, MI 49007
Phone (269) 341-7887

601 John St
#42
Kalamazoo, MI 49007
Phone (269) 341-7806

301 John St
#42
Kalamazoo, MI 49007

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

Interoperability endpoints

  • Direct secure messaging: direct@direct.bronsonhg.org

Organizations & group practices 5

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1255359675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10400 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427884",
            "telephone_number": "262-948-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427884",
            "telephone_number": "262-948-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2650 Ridge Ave",
            "address_2": "Walgreen Building Suite 1507",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602011718",
            "country_code": "US",
            "telephone_number": "847-570-2280",
            "fax_number": "847-570-2910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 John St Ste N1100",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490075349",
            "country_code": "US",
            "telephone_number": "269-341-7887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEERHOF",
        "first_name": "MARK",
        "middle_name": "G",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "IL",
            "license": "036071277",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "81-321",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "MI",
            "license": "EMC0003938",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mneerhof5523@direct.northshore.org",
            "affiliation": "N",
            "address_1": "2650 Ridge Ave",
            "address_2": "Walgreen Building Suite 1507",
            "city": "Evanston",
            "state": "IL",
            "country_code": "US",
            "postal_code": "602011718",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mneerhof5523@direct.northshore.org",
            "affiliation": "N",
            "address_1": "2650 Ridge Ave",
            "address_2": "Walgreen Building Suite 1507",
            "city": "Evanston",
            "state": "IL",
            "country_code": "US",
            "postal_code": "602011718",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson HealthCare Group Direct Address",
            "affiliationName": "Bronson HealthCare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.