NPIMap

Organization Active NPI

Orthomidwest, PLLC

  • Orthopaedic Surgery Physician
  • Algonquin, IL
National Provider Identifier
1477049070
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOMIDWEST, PLLC
Practice address
650 S Randall Rd
Algonquin, IL 60102-5944
Phone
(815) 398-9491
NPI assigned
Jul 6, 2018
Last updated
Apr 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Authorized official

Name
Leslie Elmer
Title
Manager, Credentialing and Risk Man
Phone
(815) 381-7431

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

650 S Randall Rd
Algonquin, IL 60102-5944

Mailing address

PO Box 735263
Chicago, IL 60673-5263
Phone (181) 538-1743

Other names 1

  • OrthoIllinois Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190422001281 IL DME Supplier - Physician - Orthopedic/Orthopedic Surgery 0749183713 Practice locations: Algonquin, IL

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

National Provider Directory

National Provider Directory
Tax ID family
Orthomidwest PLLC30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713484800000",
    "number": "1477049070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735263",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735263",
            "telephone_number": "181-538-1743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 S RANDALL RD",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601025944",
            "telephone_number": "815-398-9491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOMIDWEST, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-06",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A",
        "authorized_official_last_name": "ELMER",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "MANAGER, CREDENTIALING AND RISK MAN",
        "authorized_official_telephone_number": "815-381-7431"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OrthoIllinois",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Algonquin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.