NPIMap

Individual provider Active NPI

Samuel Lespinasse, M.D.

  • General Practice Physician
  • Cicero, IL
National Provider Identifier
1356617849
Registry record updated Mar 28, 2012
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Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
036089342 Issued in IL
Practice address
1904 S Cicero Ave
Cicero, IL 60804-2545
Phone
(773) 263-9382
NPI assigned
Mar 28, 2012
Last updated
Mar 28, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 036089342 IL Primary

Addresses

Primary practice location

1904 S Cicero Ave
Cicero, IL 60804-2545

Mailing address

5940 N Drake Ave
Chicago, IL 60659-3203
Phone (773) 263-9382

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120808000349 IL Practitioner - Family PracticePractitioner - General Practice 0345223376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
Loma Linda University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physicians to You Home Health LimitedGroup PAC ID 5193972164, 10 clinicians

Practice addresses (Care Compare)

6916 Cermak Rd
Berwyn, IL 60402-2244
Phone (708) 933-3840

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians to You Home Health Limited CurrentSince Sep 13, 2017 Accepting new patients
Traveling Doc Inc. General Practice Past Accepting new patients

Locations

6916 Cermak Rd
Berwyn, IL 60402
Phone (708) 933-3840

Interoperability endpoints

  • Direct secure messaging: slespinasse@phytou.curemd.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332892800000",
    "number": "1356617849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5940 N DRAKE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593203",
            "telephone_number": "773-263-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 S CICERO AVE",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608042545",
            "telephone_number": "773-263-9382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESPINASSE",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-28",
        "last_updated": "2012-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036089342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cicero, IL

Sources for this page

Verify at the official NPI Registry.