Individual provider Active NPI

Ellery Reyes Ho, D.P.M.

  • Podiatrist
  • Northbrook, IL
National Provider Identifier
1285668459
Registry record updated May 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
07000983A Issued in IN
Practice address
425 Huehl Rd
Unit #13
Northbrook, IL 60062-2319
Phone
(847) 504-5000
Fax
(847) 504-5015
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 07000983A IN Primary

Addresses

Primary practice location

425 Huehl Rd
Unit #13
Northbrook, IL 60062-2319

Mailing address

425 Huehl Rd
Unit #13
Northbrook, IL 60062-2319
Phone (847) 504-5000

Other identifiers 2

IdentifierTypeStateIssuer
200247020AMedicaidIN
0732240001OtherDMERC # WITH PPG

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041005001274 IN Practitioner - Podiatry 9739148792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Preferred Podiatry Group PCGroup PAC ID 3971412677, 131 clinicians

Practice addresses (Care Compare)

1 Sisters of Providence
Saint Mary of the Woods, IN 47876-1007
Phone (812) 535-1050

Merit-based Incentive Payment System (MIPS)

Final score
87.82 of 100Reported as group
Quality
72.99
Improvement activities
40
Cost
75.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue3362
Removal or shaving of skin growth110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Podiatry Group PC Podiatrist CurrentSince Aug 17, 2004 Accepting new patients

Locations

425 Huehl Rd
Unit 13
Northbrook, IL 60062
Phone (800) 654-3772

762 N Dan Jones Rd
Avon, IN 46123
Phone (201) 856-0224

1 Sisters of Providence
St Mary of Wd, IN 47876
Phone (812) 535-1051

Interoperability endpoints

  • Direct secure messaging: elleryho@ppgp-il.direct.office.nextgen.com

Organizations & group practices 1

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369785600000",
    "number": "1285668459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 HUEHL RD",
            "address_2": "UNIT #13",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622319",
            "telephone_number": "847-504-5000",
            "fax_number": "847-504-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 HUEHL RD",
            "address_2": "UNIT #13",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622319",
            "telephone_number": "847-504-5000",
            "fax_number": "847-504-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HO",
        "first_name": "ELLERY",
        "middle_name": "REYES",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2013-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07000983A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200247020A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC # WITH PPG",
            "identifier": "0732240001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.