Individual provider Active NPI

Peter A Smith, M.D.

  • Orthopaedic Surgery Physician
  • Chicago, IL
National Provider Identifier
1518071398
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036072267 Issued in IL
Practice address
2211 North Oak Park Avenue
Shriners Hospital for Children Chicago
Chicago, IL 60707-3392
Phone
(773) 385-5492
Fax
(773) 385-5488
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 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 036072267 IL Primary

Addresses

Primary practice location

2211 North Oak Park Avenue
Shriners Hospital for Children Chicago
Chicago, IL 60707-3392

Mailing address

P.O. Box 8500, Lockbox 7642
Shriners Hospital for Children Chicago
Philadelphia, PA 19178-7642
Phone (813) 281-8115

Other identifiers 1

IdentifierTypeStateIssuer
036072267OtherILSTATE LICENSE PHYSICIAN

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
I20131024000539 IL Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 5698900801 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shriners Hospitals for Children CurrentSince Jan 1, 2012 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Cook County Current Accepting new patients
Cook County CurrentSince Apr 22, 2021 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Oct 1, 2015 Accepting new patients
Shriners Hospitals for Children CurrentSince Jan 1, 2012 Accepting new patients
Board of Trustees of the University of Illinois CurrentSince Oct 1, 2015 Accepting new patients
Shriners Hospitals for Children Current Accepting new patients
Cook County CurrentSince Apr 22, 2021 Accepting new patients
The Board of Trustees of the University of Illinois Orthopaedic Surgery Past Accepting new patients
Shriners Hospitals for Children Past Accepting new patients

Locations

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

2211 N Oak Park Ave
Chicago, IL 60707
Phone (773) 385-5463

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

7732 Solution Ctr
Dept 3457
Chicago, IL 60677

901 S Wolcott Ave
Chicago, IL 60612
Phone (312) 996-3470

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1518071398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 8500, LOCKBOX 7642",
            "address_2": "SHRINERS HOSPITAL FOR CHILDREN CHICAGO",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191787642",
            "telephone_number": "813-281-8115",
            "fax_number": "813-281-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 NORTH OAK PARK AVENUE",
            "address_2": "SHRINERS HOSPITAL FOR CHILDREN CHICAGO",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607073392",
            "telephone_number": "773-385-5492",
            "fax_number": "773-385-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PETER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036072267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE PHYSICIAN",
            "identifier": "036072267",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.