Individual provider Active NPI

Paul Smith, DPM

  • Foot & Ankle Surgery Podiatrist
  • Western Springs, IL
National Provider Identifier
1396298642
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016.005833 Issued in IL
Practice address
915 55TH St Ste 200
Western Springs, IL 60558-2267
Phone
(708) 352-5652
Fax
(708) 482-7465
NPI assigned
Aug 3, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 016.005833 IL Primary

Addresses

Primary practice location

915 55TH St Ste 200
Western Springs, IL 60558-2267

Mailing address

915 55TH St Ste 200
Western Springs, IL 60558-2267
Phone (708) 352-5652

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
I20190515002470 IL Practitioner - Podiatry 1355635459 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DRS Bonet and Doyle PTRSGroup PAC ID 1153352349, 3 clinicians

Practice addresses (Care Compare)

915 55TH St
Suite 200
Western Springs, IL 60558-2267
Phone (708) 352-5652

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.64 of 100Reported as group
Quality
70.57
Promoting interoperability
100
Improvement activities
40
Cost
68.22

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue316
Removal of skin lesions25
Removal of nail tissue470
Removal or shaving of skin growth82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016.005833ILMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Partners, Inc Single Specialty CurrentSince Jun 20, 2024 Accepting new patients
DRS. Bonet and Doyle PTRS Single Specialty CurrentSince Apr 9, 2019 Accepting new patients
DRS. Bonet and Doyle PTRS Single Specialty CurrentSince Apr 9, 2019 Accepting new patients
Orthotec Surgery Center, Inc Past Accepting new patients

Locations

9050 W 81st St
Ste 500
Justice, IL 60458
Phone (312) 375-4788

5101 Willow Springs Rd
Lagrange Hlds, IL 60525
Phone (708) 245-4073

1415 W 47th St
Lagrange Hlds, IL 60525
Phone (708) 352-5652

915 55th St
Ste 200
Western Springs, IL 60558
Phone (708) 352-5652

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFDBCD
  • FHIR API: https://api.platform.athenahealth.com/14157/brand/1/csg/1/fhir/r4

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.

Hospital & facility affiliations 4

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": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1396298642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 55TH ST STE 200",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605582267",
            "telephone_number": "708-352-5652",
            "fax_number": "708-482-7465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 55TH ST STE 200",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605582267",
            "telephone_number": "708-352-5652",
            "fax_number": "708-482-7465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PAUL",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-03",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016.005833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Western Springs, IL

Sources for this page

Verify at the official NPI Registry.