Individual provider Active NPI

Timothy Craig Wirt, DPM

  • Foot & Ankle Surgery Podiatrist
  • Geneva, IL
National Provider Identifier
1417308925
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016.005856 Issued in IL
Practice address
351 Delnor Dr Ste 401
Geneva, IL 60134-4235
Phone
(630) 933-4056
NPI assigned
Jun 27, 2016
Last updated
Aug 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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 Podiatrist 213ES0103X 016.005856 IL Primary

Addresses

Primary practice location

351 Delnor Dr Ste 401
Geneva, IL 60134-4235

Mailing address

680 North Lake Shore Drive
Chicago, IL 60611-2987
Phone (312) 695-6868

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
I20190906001497 IL Practitioner - Podiatry 1052640638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

351 Delnor Dr
Suite 410
Geneva, IL 60134-4235

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue12
Removal of skin lesions20
Removal of nail tissue26
Removal or shaving of skin growth28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016.005856ILMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Sep 16, 2019 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 16, 2023 Accepting new patients
Central Dupage Physician Group CurrentSince Sep 16, 2019 Accepting new patients
Northwestern Medical Faculty Foundation PastSince Aug 18, 2019 Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

351 Delnor Dr
Geneva, IL 60134
Phone (630) 262-1001

351 Delnor Dr
Ste 401
Geneva, IL 60134

351 Delnor Dr
Ste 410
Geneva, IL 60134
Phone (630) 232-6354

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1417308925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 NORTH LAKE SHORE DRIVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112987",
            "telephone_number": "312-695-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 DELNOR DR STE 401",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344235",
            "telephone_number": "630-933-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRT",
        "first_name": "TIMOTHY",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-27",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016.005856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

Verify at the official NPI Registry.