Individual provider Active NPI

Peter David Geldner, MD

  • Plastic Surgery Physician
  • Chicago, IL
National Provider Identifier
1497866289
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
36069136 Issued in IL
Practice address
680 N Lake Shore Dr
Ste 1325
Chicago, IL 60611
Phone
(312) 981-4440
Fax
(312) 981-4441
NPI assigned
Aug 31, 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
Plastic Surgery Physician 208200000X 36069136 IL Primary

Addresses

Primary practice location

680 N Lake Shore Dr
Ste 1325
Chicago, IL 60611

Mailing address

680 N Lake Shore Dr
Ste 1325
Chicago, IL 60611
Phone (312) 981-4440

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
I20041025000457 IL Practitioner - Plastic and Reconstructive Surgery 5496716474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Wisconsin School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

680 N Lake Shore Dr
Suite 1325
Chicago, IL 60611-4546

680 N Lake Shore Dr
Suite 1325
Chicago, IL 60611-8701
Phone (312) 981-4440

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36069136ILMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peter D. Geldner, M.D. S.C. Plastic Surgery CurrentSince Sep 12, 2003 Accepting new patients

Locations

680 N Lake Shore Dr
Ste 13
Chicago, IL 60611
Phone (312) 981-4440

680 N Lake Shore Dr
Ste 1325
Chicago, IL 60611
Phone (312) 981-4440

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497866289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "STE 1325",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "312-981-4440",
            "fax_number": "312-981-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "STE 1325",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "312-981-4440",
            "fax_number": "312-981-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELDNER",
        "first_name": "PETER",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": "36069136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.