Individual provider Active NPI

Jeremy Smiley

  • Emergency Medicine Physician
  • Evanston, IL
National Provider Identifier
1376868661
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036131259 Issued in IL
Practice address
2650 Ridge Ave
Evanston, IL 60201-1718
Phone
(847) 570-2114
NPI assigned
Mar 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036131259 IL Primary

Addresses

Primary practice location

2650 Ridge Ave
Evanston, IL 60201-1718

Mailing address

2650 Ridge Ave
RM G909
Evanston, IL 60201-1718

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
I20140402000438 IL Practitioner - Emergency MedicinePractitioner - Internal Medicine 8224269428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2100 Pfingsten Rd
Glenview, IL 60026-1301

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036131259ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Emergency Medicine Current Accepting new patients
Endeavor Health Medical Group CurrentSince Jun 1, 2015 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Rm G909
Evanston, IL 60201
Phone (847) 570-2114

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

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 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": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1376868661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "RM G909",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMILEY",
        "first_name": "JEREMY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-30",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036131259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.