NPIMap

Individual provider Active NPI

Jared Hart, DPM

  • Foot & Ankle Surgery Podiatrist
  • Libertyville, IL
National Provider Identifier
1437611324
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016005973 Issued in IL
Practice address
1870 W Winchester Rd Ste 246
Libertyville, IL 60048-5360
Phone
(847) 816-3156
NPI assigned
Apr 1, 2019
Last updated
Jun 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 016005973 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1870 W Winchester Rd Ste 246
Libertyville, IL 60048-5360

Mailing address

1870 W Winchester Rd Ste 246
Libertyville, IL 60048-5360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220524000461 IL Practitioner - Podiatry 5395122790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
R Franklin University of Med & Sci/Chicago Medical School, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Gail Kwiecinski DPM P CGroup PAC ID 9436332418, 3 clinicians

Practice addresses (Care Compare)

1870 W Winchester Rd
Suite 246
Libertyville, IL 60048-5360
Phone (847) 816-3156

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.66 of 100Reported as individual
Quality
69.67
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue35
Removal of skin lesions1-10
Removal of nail tissue346
Removal or shaving of skin growth197
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016005973ILMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Libertyville Podiatry PC Foot & Ankle Surgery CurrentSince Jul 1, 2022 Accepting new patients

Locations

1870 W Winchester Rd
Ste 246
Libertyville, IL 60048
Phone (847) 362-5344

801 S Milwaukee Ave
Libertyville, IL 60048
Phone (847) 362-2900

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

Hospital & facility affiliations 7

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": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1437611324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 W WINCHESTER RD STE 246",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 W WINCHESTER RD STE 246",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485360",
            "telephone_number": "847-816-3156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "JARED",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-01",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005973",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.