Individual provider Active NPI

Wayne Goldstein, MD

  • Orthopaedic Surgery Physician
  • Morton Grove, IL
National Provider Identifier
1477507127
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036-059119 Issued in IL
Practice address
9000 Waukegan Rd
Suite 200
Morton Grove, IL 60053-2111
Phone
(847) 375-3000
NPI assigned
May 19, 2006
Last updated
Aug 28, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 036-059119 IL Primary

Addresses

Primary practice location

9000 Waukegan Rd
Suite 200
Morton Grove, IL 60053-2111

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
036-059119MedicaidIL

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061206000399 IL Practitioner - Orthopedic Surgery 0345152468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2101 Waukegan Rd
Bannockburn, IL 60015-1836

350 S Greenleaf St
Gurnee, IL 60031-5709

521 Green Bay Rd
Wilmette, IL 60091-2726
Phone (847) 996-5680

718 Florsheim Dr
Libertyville, IL 60048-3757
Phone (847) 362-4483

720 Florsheim Dr
Libertyville, IL 60048-3757
Phone (847) 247-4000

724 Florsheim Dr
Libertyville, IL 60048-3757
Phone (847) 247-4000

9000 Waukegan Rd
Morton Grove, IL 60053-2127
Phone (847) 213-5444

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-059119ILMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Bone and Joint Institute LLC Orthopaedic Surgery CurrentSince Jan 1, 2007 Accepting new patients
Illinois Bone and Joint Institute, LLC Orthopaedic Surgery CurrentSince Dec 1, 2005 Accepting new patients
Illinois Bone and Joint Institute Orthopaedic Surgery Past Accepting new patients
Pain Care Consultants, S.C. Past 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

716 Florsheim Dr
Libertyville, IL 60048
Phone (847) 918-9077

9000 Waukegan Rd
Ste 200
Morton Grove, IL 60053

1875 W Dempster St
Ste 405
Park Ridge, IL 60068
Phone (312) 372-6644

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/Freedom_IBJI
  • FHIR API: https://epicproxy.et1195.epichosted.com/fhirproxy/api/FHIR/R4/

Organizations & group practices 108

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.

View all 108

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1477507127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RAND RD STE 300",
            "address_2": "ATTN: RAQUEL LEON",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162359",
            "telephone_number": "847-324-3976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 WAUKEGAN RD",
            "address_2": "SUITE 200",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532111",
            "telephone_number": "847-375-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "WAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036-059119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-059119",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton Grove, IL

Sources for this page

Verify at the official NPI Registry.