Andre Ivy, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

125-058363 Issued in IL

Practice address

1801 S Highland Ave Ste 220
Lombard, IL 60148-4932

Phone

(630) 790-1872

Fax

(630) 873-8812

NPI assigned

Jun 25, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Orthopedic Surgery

Education

University of Cincinnati College of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elmhurst Memorial Hospital Hospital, Elmhurst, IL, CCN 140200

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Dupage Medical Group LTD

  • Multi-Specialty Clinic/Center
  • Downers Grove, IL
  • NPI 1801833983
  Medicare reassignment Care Compare group NPD
• Dupage Medical Group LTD

  • Durable Medical Equipment & Medical Supplies
  • Glen Ellyn, IL
  • NPI 1760979447
  NPD
• DMG Surgical Center LLC

  • Ambulatory Surgical Clinic/Center
  • Lombard, IL
  • NPI 1710924899
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Elmhurst Memorial Hospital

  • General Acute Care Hospital
  • Elmhurst, IL
  • NPI 1548306343
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1346551280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 S HIGHLAND AVE STE 220",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484932",
            "telephone_number": "630-790-1872",
            "fax_number": "630-873-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVY",
        "first_name": "ANDRE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-25",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "125-058363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aivy122045@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "1801 S Highland Ave Ste 220",
            "city": "Lombard",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601484932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Integrated Pain Management SC
• Integrative Family Counseling LLC
• Integrative Pathways PLLC
• Intelliride, LLC
• Madeline L Intud, FNP-BC
• Destyne Jackson
• Priscilla Earline Jackson, NMD
• Maliheh S. Jahedi, DMD
• Olivia Jakubas
• Melissa Jama

• Orthopaedic Surgery Physician in Lombard, IL
• Providers in Lombard, IL by specialty
• Orthopaedic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.