Kyle S. Peterson, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016005623 Issued in IL

Practice address

1110 W Schick Rd
Bartlett, IL 60103-3007

Phone

(630) 372-1100

Fax

(630) 483-0852

NPI assigned

Mar 19, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Specialty

Podiatry

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Suburban Orthopaedics LTDGroup PAC ID 7113950700, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Sherman Hospital Hospital, Elgin, IL, CCN 140030
• St Alexius Medical Center Hospital, Hoffman Estates, IL, CCN 140290
• Elmhurst Memorial Hospital Hospital, Elmhurst, IL, CCN 140200
• Alexian Brothers Medical Center 1 Hospital, Elk Grove Village, IL, CCN 140258

Merit-based Incentive Payment System (MIPS)

Final score

66.79 of 100Reported as group

Quality

24.52

Promoting interoperability

96

Improvement activities

40

Cost

65.68

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Suburban Orthopaedics LTD

  • Orthopaedic Surgery Physician
  • Bartlett, IL
  • NPI 1275749475
  Medicare reassignment Care Compare group NPD
• Ohio Foot & Ankle, Inc

  • Orthopaedic Foot and Ankle Surgery Physician
  • Worthington, OH
  • NPI 1659364503
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate Sherman Hospital

  • General Acute Care Hospital
  • Elgin, IL
  • NPI 1629026364
  Care Compare affiliation
• Alexian Brothers Medical Center

  • General Acute Care Hospital
  • Elk Grove Village, IL
  • NPI 1265577191
  Care Compare affiliation
• Elmhurst Memorial Hospital

  • General Acute Care Hospital
  • Elmhurst, IL
  • NPI 1548306343
  Care Compare affiliation
• Sherman Hospital

  • Skilled Nursing Facility
  • Elgin, IL
  • NPI 1275584302

  Hospital

  Care Compare affiliation
• St. Alexius Medical Center

  • General Acute Care Hospital
  • Hoffman Estates, IL
  • NPI 1376644385
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1300492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1417256272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 W SCHICK RD",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601033007",
            "telephone_number": "630-372-1100",
            "fax_number": "614-895-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W SCHICK RD",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601033007",
            "telephone_number": "630-372-1100",
            "fax_number": "630-483-0852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KYLE",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-19",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006240",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005623",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36003642",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PODIATRIC LICENSE NUMBER",
            "identifier": "SC006240",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vinod M. Patel, MD
• Arpit J Pathak, DPT
• Nicole A Pawola, D.C.
• Scott Marshal Payne, DC
• Rory M Perry, OTR/L
• Daniela Petrova
• Steven Ryan Petzel, DC
• Robyn Nicole Pidu
• Deborah Pincsak
• Lisa Carole Pinn, DVM

• Foot & Ankle Surgery Podiatrist in Bartlett, IL
• Providers in Bartlett, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.