Individual provider Active NPI

Sergey Neckrysh, MD

  • Neurological Surgery Physician
  • Chicago, IL
National Provider Identifier
1285736637
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
036-113099 Issued in IL
Practice address
912 S. Wood STR
Department of Neurosurgery MC 799
Chicago, IL 60612
Phone
(312) 996-4842
Fax
(312) 996-9018
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 036-113099 IL Primary
Neurological Surgery Physician 207T00000X 036113099 IL

Addresses

Primary practice location

912 S. Wood STR
Department of Neurosurgery MC 799
Chicago, IL 60612

Mailing address

912 S. Wood STR
Department of Neurosurgery MC 799
Chicago, IL 60612
Phone (312) 996-4842

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20101105000215 IL Practitioner - Neurosurgery 3274622493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, 1,134 clinicians

Practice addresses (Care Compare)

1740 W Taylor St
Chicago, IL 60612-7232

1801 W Taylor St
Chicago, IL 60612-4795

4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone (708) 684-8000

Hospital & facility affiliations

  • University of Illinois Hospital and Clinics Hospital, Chicago, IL, CCN 140150

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion45
Laminectomy or laminotomy (partial removal of spine bones)11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-113099ILMDNeurological Surgery Physician
036113099ILMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince May 11, 2010 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince May 11, 2010 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
University Spine Surgeons, LLC Neurological Surgery Current Accepting new patients
Academic Spine Consultants, LLC Neurological Surgery Current Accepting new patients
Neurosurgical Associates of Central New York, LLP Past Accepting new patients
Upstate Neurosurgery LLP Neurological Surgery PastSince Jan 15, 2024 Accepting new patients
Board of Trustees of the University of Illinois Past Accepting new patients

Locations

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

1801 W Taylor St
Chicago, IL 60612
Phone (312) 355-1700

1740 W Taylor St
Ste 1400
Chicago, IL 60612
Phone (312) 996-3900

912 S Wood St
#799
Chicago, IL 60612
Phone (312) 413-0684

4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520

Organizations & group practices 8

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 1

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1285736637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 S. WOOD STR",
            "address_2": "DEPARTMENT OF NEUROSURGERY MC 799",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-996-4842",
            "fax_number": "312-996-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 S. WOOD STR",
            "address_2": "DEPARTMENT OF NEUROSURGERY MC 799",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-996-4842",
            "fax_number": "312-996-9018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NECKRYSH",
        "first_name": "SERGEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036-113099",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036113099",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.