Individual provider Active NPI

John Groth, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Evanston, IL
National Provider Identifier
1417159294
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
036126085 Issued in IL
Practice address
2650 Ridge Ave.
Department of Pathology
Evanston, IL 60201-1718
Phone
(847) 570-2730
NPI assigned
Jun 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036126085 IL Primary

Addresses

Primary practice location

2650 Ridge Ave.
Department of Pathology
Evanston, IL 60201-1718

Mailing address

206 Garfield Ave
Libertyville, IL 60048-2756
Phone (847) 573-1977

Other practice location 1

1740 W Taylor St
Chicago, IL 60612-7232
Phone (866) 600-2273

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
I20131204001593 IL Practitioner - Pathology 4789810367 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2007
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)

2500 Ridge Ave
Evanston, IL 60201-2455
Phone (847) 328-3500

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Swedish Hospital Hospital, Chicago, IL, CCN 140114

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
036126085ILMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Mar 1, 2019 Accepting new patients
Endeavor Health Medical Group CurrentSince Mar 1, 2019 Accepting new patients
Board of Trustees of the University of Illinois Anatomic Pathology & Clinical Pathology CurrentSince Sep 6, 2013 Accepting new patients
The Board of Trustees of the University of Illinois Anatomic Pathology & Clinical Pathology Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Sep 6, 2013 Accepting new patients

Locations

1740 W Taylor St
#931
Chicago, IL 60612
Phone (312) 355-5258

9532 Eagle Way
Chicago, IL 60678

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

1819 W Polk St
Chicago, IL 60612
Phone (312) 996-6604

1740 W Taylor St
Chicago, IL 60612
Phone (312) 355-4000

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

2500 Ridge Ave
Evanston, IL 60201
Phone (847) 328-3500

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

9977 Woods Dr
Skokie, IL 60077
Phone (847) 663-8540

Organizations & group practices 5

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 2

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": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1417159294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 GARFIELD AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482756",
            "telephone_number": "847-573-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE.",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-2730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1740 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606127232",
            "country_code": "US",
            "telephone_number": "866-600-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROTH",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036126085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.