Individual provider Active NPI

R. Guy MC Dermott, D.O.

  • Anesthesiology Physician
  • Barrington, IL
National Provider Identifier
1487653275
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036098076 Issued in IL
Practice address
450 W Highway 22
Barrington, IL 60010-7509
Phone
(847) 381-9600
NPI assigned
Jul 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036098076 IL Primary

Addresses

Primary practice location

450 W Highway 22
Barrington, IL 60010-7509

Mailing address

255 W Michigan Ave
Jackson, MI 49201-2218
Phone (517) 787-6440

Other identifiers 2

IdentifierTypeStateIssuer
04922488OtherILBLUE SHIELD OF ILLINOIS
036098076MedicaidIL

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
I20080414000536 IL Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 9537246699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management
Education
Ohio University, College of Osteopathic Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barrington Anesthesia Associates, SCGroup PAC ID 3870667256, 20 clinicians

Practice addresses (Care Compare)

450 W Hwy 22
Barrington, IL 60010-1919
Phone (847) 381-9600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036098076ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barrington Anesthesia Associates, SC Anesthesiology CurrentSince May 1, 2008 Accepting new patients

Locations

8135 N Milwaukee Ave
Niles, IL 60714
Phone (847) 967-1149

450 W State Route 22
South Barrington, IL 60010
Phone (847) 381-0123

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1487653275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "517-787-6440",
            "fax_number": "517-768-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 W HIGHWAY 22",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600107509",
            "telephone_number": "847-381-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MC DERMOTT",
        "first_name": "R.",
        "middle_name": "GUY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036098076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF ILLINOIS",
            "identifier": "04922488",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098076",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Barrington, IL

Sources for this page

Verify at the official NPI Registry.