Individual provider Active NPI

Dmitry Pyatetsky, M.D.

  • Ophthalmology Physician
  • Chicago, IL
National Provider Identifier
1497775993
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Practice address
675 N Saint Clair St
Dept. of Ophthalmology
Chicago, IL 60611-5975
Phone
(312) 695-8150
Fax
(312) 503-8152
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X IL Primary

Addresses

Primary practice location

675 N Saint Clair St
Dept. of Ophthalmology
Chicago, IL 60611-5975

Mailing address

8021 Kolmar Ave
Skokie, IL 60076-3114
Phone (312) 286-7936

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
I20050917000258 IL Practitioner - Ophthalmology 3476586660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Northwestern University Feinberg Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1630 Sherman Ave
Evanston, IL 60201-3711

259 E Erie St
Chicago, IL 60611-2930
Phone (312) 503-1944

636 Raymond Dr
Suite 107
Naperville, IL 60563-9789
Phone (630) 416-2300

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery275

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-113364ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2006 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2006 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

675 N Saint Clair St
Chicago, IL 60611
Phone (312) 664-3278

259 E Erie St
Ste 1520
Chicago, IL 60611
Phone (312) 227-6180

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

1630 Sherman Ave
Ste 100
Evanston, IL 60201
Phone (224) 271-4860

Organizations & group practices 3

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497775993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8021 KOLMAR AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600763114",
            "telephone_number": "312-286-7936",
            "fax_number": "847-679-6533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST",
            "address_2": "DEPT. OF OPHTHALMOLOGY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115975",
            "telephone_number": "312-695-8150",
            "fax_number": "312-503-8152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PYATETSKY",
        "first_name": "DMITRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.