Individual provider Active NPI

Gary Trent, D.P.M.

  • Podiatrist
  • Schaumburg, IL
National Provider Identifier
1376694570
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016-004438 Issued in IL
Practice address
711 Tipperary CT Apt 2B
Schaumburg, IL 60193-3226
Phone
(773) 445-4525
Fax
(773) 232-0389
NPI assigned
Jan 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016-004438 IL Primary

Addresses

Primary practice location

711 Tipperary CT Apt 2B
Schaumburg, IL 60193-3226

Mailing address

711 Tipperary CT Apt 2B
Schaumburg, IL 60193-3226
Phone (312) 406-1280

Other identifiers 1

IdentifierTypeStateIssuer
60001758OtherILBLUE CROSSBLUE SHIELD

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041115000127 IL Practitioner - Podiatry 8325002934 Practice locations: Chicago, IL; Des Plaines, IL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016-004438ILMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Schaumburg Podiatry Center, Inc Past Accepting new patients
Access Health Care, Inc. Past Accepting new patients
M McNeill DPM Incorporated Past Accepting new patients
Gary a. Trent, D.P.M. Podiatrist PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 4

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1376694570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TIPPERARY CT APT 2B",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601933226",
            "telephone_number": "312-406-1280",
            "fax_number": "773-232-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 TIPPERARY CT APT 2B",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601933226",
            "telephone_number": "773-445-4525",
            "fax_number": "773-232-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRENT",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016-004438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSSBLUE SHIELD",
            "identifier": "60001758",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.