Individual provider Active NPI

Alyssa Goergen

  • Nurse Practitioner
  • Western Springs, IL
National Provider Identifier
1457026320
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.023500 Issued in IL
Practice address
4700 Gilbert Ave Ste 51
Western Springs, IL 60558-1664
Phone
(708) 387-1737
NPI assigned
Aug 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.023500 IL Primary

Addresses

Primary practice location

4700 Gilbert Ave Ste 51
Western Springs, IL 60558-1664

Mailing address

900 Rand Rd Ste 300
Des Plaines, IL 60016-2359
Phone (847) 324-3976

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210916000665 IL Practitioner - Nurse Practitioner 5698172716 Reassigns benefits to 1 organization
I20231213002084 IN Practitioner - Nurse Practitioner 5698172716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Illinois Bone and Joint Institute, LLCGroup PAC ID 6002814878, 603 clinicians

Practice addresses (Care Compare)

4700 Gilbert Ave
Suite 51
Western Springs, IL 60558-1664
Phone (708) 387-1750

Hospital & facility affiliations

  • Uchicago Medicine Adventhealth Hinsdale Hospital, Hinsdale, IL, CCN 140122
  • Uchicago Medicine Adventhealth la Grange Hospital, La Grange, IL, CCN 140065

Merit-based Incentive Payment System (MIPS)

Final score
81.07 of 100Reported as group
Quality
76.54
Promoting interoperability
83
Improvement activities
40
Cost
74.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.023500ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Bone and Joint Institute, LLC CurrentSince Sep 7, 2021 Accepting new patients
Illinois Bone and Joint Institute LLC CurrentSince Sep 7, 2021 Accepting new patients

Locations

2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096

5057 Paysphere Cir
Chicago, IL 60674

900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090

550 W Ogden Ave
Hinsdale, IL 60521
Phone (630) 323-6116

4700 Gilbert Ave
Ste 51
Western Springs, IL 60558
Phone (708) 387-1737

1010 Executive Dr
Ste 250
Westmont, IL 60559
Phone (630) 655-8785

10110 Donald S Powers Dr
Ste 101B
Munster, IN 46321
Phone (219) 961-8480

Organizations & group practices 2

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 4

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": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1457026320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RAND RD STE 300",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162359",
            "telephone_number": "847-324-3976",
            "fax_number": "847-929-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 GILBERT AVE STE 51",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581664",
            "telephone_number": "708-387-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOERGEN",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.023500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Western Springs, IL

Sources for this page

Verify at the official NPI Registry.