Individual provider Active NPI

Geraldine Holtz, NP

  • Nurse Practitioner
  • McHenry, IL
National Provider Identifier
1518411081
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209014862 Issued in IL
Practice address
4309 W Medical Center Dr Ste B305
McHenry, IL 60050-8418
Phone
(847) 802-7400
NPI assigned
Aug 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.014862 IL
Nurse Practitioner 363L00000X 209014862 IL Primary

Addresses

Primary practice location

4309 W Medical Center Dr Ste B305
McHenry, IL 60050-8418

Mailing address

4309 W Medical Center Dr Ste B305
McHenry, IL 60050-8418
Phone (847) 802-7400

Other practice location 1

10350 Haligus Rd Ste C
Huntley, IL 60142-9545
Phone (847) 802-7400

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170126000449 IL Practitioner - Nurse Practitioner 6800178823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

4309 W Medical Ctr Dr
McHenry, IL 60050-8419
Phone (815) 338-6600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.014862ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Aug 26, 2020 Accepting new patients
Central Dupage Physician Group CurrentSince Aug 26, 2020 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

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

10350 Haligus Rd
Ste C
Huntley, IL 60142
Phone (312) 695-3800

10350 Haligus Rd
Huntley, IL 60142
Phone (847) 802-7150

4309 W Medical Center Dr
Ste B305
McHenry, IL 60050
Phone (847) 802-7400

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 2

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 3

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": "1470960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1518411081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 W MEDICAL CENTER DR STE B305",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508418",
            "telephone_number": "847-802-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 W MEDICAL CENTER DR STE B305",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508418",
            "telephone_number": "847-802-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10350 Haligus Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601429545",
            "country_code": "US",
            "telephone_number": "847-802-7400",
            "fax_number": "847-802-7399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLTZ",
        "first_name": "GERALDINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-12",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.014862",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209014862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

Verify at the official NPI Registry.