Individual provider Active NPI

Michael John Meeker, PA-C

  • Surgical Physician Assistant
  • Orland Park, IL
National Provider Identifier
1407809528
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085-002153 Issued in IL
Practice address
10719 West 160TH Street
Orland Park, IL 60467-5541
Phone
(708) 226-3300
Fax
(708) 226-4202
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 085-002153 IL Primary

Addresses

Primary practice location

10719 West 160TH Street
Orland Park, IL 60467-5541

Mailing address

75 Remittance Drive
Suite 6581
Chicago, IL 60675-6581
Phone (708) 226-3300

Other identifiers 2

IdentifierTypeStateIssuer
P00143140OtherILRAILROAD MEDICARE PROVIDER NUMBER
085002153OtherILBLUE CROSS/BLUE SHIELD PROVIDER NUMBER

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mmeeker263179@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041130000670 IL Practitioner - Physician Assistant 2365407483 Reassigns benefits to 1 organization
I20180509001188 IN Practitioner - Physician Assistant 2365407483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Orthopedic Consultants SCGroup PAC ID 8022911031, 27 clinicians

Practice addresses (Care Compare)

10719 160TH St
Orland Park, IL 60467-5541
Phone (708) 226-3300

9200 Calumet Ave
Suite 100
Munster, IN 46321-2885
Phone (219) 595-0789

Hospital & facility affiliations

  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Advocate Trinity Hospital Hospital, Chicago, IL, CCN 140048

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-002153ILMDSurgical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: mmeeker263179@direct.myadvocateaurora.org

Organizations & group practices 1

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 6

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1407809528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 REMITTANCE DRIVE",
            "address_2": "SUITE 6581",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606756581",
            "telephone_number": "708-226-3300",
            "fax_number": "708-226-4202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10719 WEST 160TH STREET",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675541",
            "telephone_number": "708-226-3300",
            "fax_number": "708-226-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEEKER",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085-002153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROVIDER NUMBER",
            "identifier": "P00143140",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD PROVIDER NUMBER",
            "identifier": "085002153",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmeeker263179@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10719 West 160th Street",
            "city": "Orland Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604675541",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "10719 West 160th Street",
            "city": "Orland Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604675541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.