Individual provider Active NPI

Jeanette A. Dubay-McDermit, CRNA

  • Certified Registered Nurse Anesthetist
  • Chicago, IL
National Provider Identifier
1427052885
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209002113 Issued in IL
Practice address
680 N Lake Shore Dr
Suite 1000
Chicago, IL 60611-4546
Phone
(312) 926-2280
NPI assigned
Jun 13, 2005
Last updated
Aug 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209002113 IL Primary

Addresses

Primary practice location

680 N Lake Shore Dr
Suite 1000
Chicago, IL 60611-4546

Mailing address

3833 N Ravenswood Ave
Chicago, IL 60613-2735
Phone (773) 665-4625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040517001240 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799775003 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Gastroenterology Group LLCGroup PAC ID 5193857423, 116 clinicians

Practice addresses (Care Compare)

800 Austin St
Suite 403
Evanston, IL 60202-3444
Phone (847) 491-9020

Merit-based Incentive Payment System (MIPS)

Final score
84.21 of 100Reported as group
Quality
67.65
Promoting interoperability
99
Improvement activities
40
Cost
80.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Gastroenterology Group, LLC CurrentSince Oct 1, 2017 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 12, 2016 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 12, 2016 Accepting new patients
Northwest Gastroenterologists SC Current Accepting new patients
Elgin Gastroenterology SC Current Accepting new patients
Northstar Anesthesia of Illinois, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 20, 2021 Accepting new patients
Elgin Gastroenterology Endoscopy Center LLC Current Accepting new patients
Endeavor Health Medical Group Past Accepting new patients
Endeavor Health Medical Group Past Accepting new patients
Aaoc Surgery Center Anesthesia LLC Past Accepting new patients
Southwest Anesthesia Consultants, LLC Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

25 E Washington St
Ste 300
Chicago, IL 60602
Phone (312) 726-3329

2900 N Lakeshore
Chicago, IL 60657
Phone (773) 665-3240

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

745 Fletcher Dr
Ste 202
Elgin, IL 60123
Phone (855) 483-7362

800 Austin St
Ste 403
Evanston, IL 60202
Phone (847) 491-9020

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

3725 W Touhy Ave
Lincolnwood, IL 60712
Phone (847) 324-7770

2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246

1775 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-5150

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1427052885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3833 N RAVENSWOOD AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132735",
            "telephone_number": "773-665-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "SUITE 1000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-926-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBAY-MCDERMIT",
        "first_name": "JEANETTE",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-13",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209002113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.