Individual provider Active NPI

Robert Wysocki, MD

  • Orthopaedic Surgery Physician
  • Chicago, IL
National Provider Identifier
1275645319
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036-116709 Issued in IL
Practice address
1611 W Harrison St
Ste 400
Chicago, IL 60612-3841
Phone
(312) 243-4244
Fax
(312) 942-1517
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X 036116709 IL
Orthopaedic Surgery Physician 207X00000X 036-116709 IL Primary

Addresses

Primary practice location

1611 W Harrison St
Ste 400
Chicago, IL 60612-3841

Mailing address

1 Westbrook Corporate Ctr
# 240
Westchester, IL 60154-5701

Other identifiers 5

IdentifierTypeStateIssuer
P00836808OtherRR MEDICARE
036116709OtherILMEDICAL LICENSE
036116709 2MedicaidIL
1633878OtherILBCBS ILLINOIS
9429369OtherAETNA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rwysocki@direct.ccprovider.org Direct Cook County

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061010000133 IL Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 8022014398 Reassigns benefits to 3 organizations
I20151210000441 IN Practitioner - Hand Surgery 8022014398 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hand SurgeryAlso: Orthopedic Surgery
Education
Northwestern University Feinberg Medical School, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthomidwest, PLLCGroup PAC ID 0749183713, 531 clinicians

Practice addresses (Care Compare)

1611 W Harrison St
Suite 400
Chicago, IL 60612-4861
Phone (877) 632-6637

9601 Calumet Ave
Munster, IN 46321-2871
Phone (877) 632-6637

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-116709ILMDOrthopaedic Surgery Physician
036116709ILMDOrthopaedic Hand Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County Current Accepting new patients
Cook County CurrentSince Nov 10, 2010 Accepting new patients
Orthomidwest, PLLC Orthopaedic Surgery CurrentSince Jul 1, 2022 Accepting new patients
Midwest Orthopaedics at Rush, LLC Orthopaedic Surgery CurrentSince Aug 1, 2009 Accepting new patients
Cook County CurrentSince Nov 10, 2010 Accepting new patients
Midwest Orthopaedics at Rush LLC CurrentSince Aug 1, 2009 Accepting new patients
Orthomidwest, PLLC CurrentSince Jul 1, 2022 Accepting new patients
Gold Coast Surgicenter, LLC PastSince May 1, 2015 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

1611 W Harrison St
#400
Chicago, IL 60612
Phone (312) 243-4244

1611 W Harrison St
Chicago, IL 60612
Phone (312) 243-4244

1969 W Ogden Ave
Chicago, IL 60612
Phone (312) 864-3600

1611 W Harrison St
Ste 400
Chicago, IL 60612
Phone (312) 243-4244

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

963 N 129th Infantry Dr
Joliet, IL 60435
Phone (815) 725-8425

55 Shuman Blvd
Ste 700
Naperville, IL 60563
Phone (630) 339-2225

1 Westbrook Corporate Ctr
Ste 240
Westchester, IL 60154

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

9200 Calumet Ave
#300
Munster, IN 46321

9601 Calumet Ave
Munster, IN 46321
Phone (312) 432-2591

Interoperability endpoints

  • Direct secure messaging: robert.wysocki.1@12576.direct.athenahealth.com

Organizations & group practices 10

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 2

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1275645319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WESTBROOK CORPORATE CTR",
            "address_2": "# 240",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601545701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST",
            "address_2": "STE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123841",
            "telephone_number": "312-243-4244",
            "fax_number": "312-942-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYSOCKI",
        "first_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "IL",
            "license": "036116709",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036-116709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00836808",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "036116709",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036116709  2",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ILLINOIS",
            "identifier": "1633878",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9429369",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rwysocki@direct.ccprovider.org",
            "affiliation": "Y",
            "affiliationName": "Cook County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1969 W. Ogden Ave.",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606123723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.