Individual provider Active NPI

Bruce R Dolitsky, MD

  • Orthopaedic Surgery Physician
  • Palos Heights, IL
National Provider Identifier
1356330286
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036065042 Issued in IL
Practice address
12255 S 80TH Ave
Palos Heights, IL 60463-1270
Phone
(708) 923-4400
Fax
(708) 923-4421
NPI assigned
Oct 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 036065042 IL Primary

Addresses

Primary practice location

12255 S 80TH Ave
Palos Heights, IL 60463-1270

Mailing address

12251 S 80TH Ave Ste 1630
Palos Heights, IL 60463-1256
Phone (708) 923-4400

Other identifiers 1

IdentifierTypeStateIssuer
036065042MedicaidIL

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
I20100605000212 IL Practitioner - Orthopedic Surgery 8224027222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

15300 W Ave BLDG a
Suite 100
Orland Park, IL 60462-4600
Phone (708) 226-2626

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

Hospital & facility affiliations

  • Palos Community Hospital Home Health Care Home health agency, Lemont, IL, CCN 147470
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement12
Knee replacement25
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Orthopaedic Surgery CurrentSince Aug 1, 2021 Accepting new patients
Central Dupage Physician Group CurrentSince Aug 1, 2021 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

1890 Silver Cross Blvd
Ste 345
New Lenox, IL 60451
Phone (815) 462-9300

15300 West Ave
Ste 122
Orland Park, IL 60462
Phone (708) 226-2400

15300 West Ave
Orland Park, IL 60462
Phone (708) 226-2440

12251 S 80th Ave
Palos Heights, IL 60463
Phone (708) 361-4500

12251 S 80th Ave
Ste 1630
Palos Heights, IL 60463
Phone (708) 923-5173

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 2

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 5

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": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1356330286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12251 S 80TH AVE STE 1630",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631256",
            "telephone_number": "708-923-4400",
            "fax_number": "708-923-4421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12255 S 80TH AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631270",
            "telephone_number": "708-923-4400",
            "fax_number": "708-923-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLITSKY",
        "first_name": "BRUCE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036065042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036065042",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.