Individual provider Active NPI

Peter William Macintosh, MD

  • Ophthalmology Physician
  • Chicago, IL
National Provider Identifier
1528229440
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036127245 Issued in IL
Practice address
1855 W Taylor St # 3.138
Chicago, IL 60612-7242
Phone
(312) 996-9120
Fax
(312) 996-7770
NPI assigned
Jun 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125054224 IL
Ophthalmology Physician 207W00000X 036127245 IL Primary

Addresses

Primary practice location

1855 W Taylor St # 3.138
Chicago, IL 60612-7242

Mailing address

1855 W Taylor St # 3.138
Chicago, IL 60612-7242
Phone (312) 996-9120

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
I20120330000269 IL Practitioner - OphthalmologyPractitioner - General Surgery 7214197102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1855 W Taylor St
Mc648
Chicago, IL 60612-7242
Phone (312) 996-6590

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125054224ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Jul 7, 2012 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois Internal Medicine CurrentSince Jul 7, 2012 Accepting new patients
Board of Trustees of the University of Illinois Internal Medicine Past Accepting new patients

Locations

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

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

1855 W Taylor St
#648
Chicago, IL 60612
Phone (312) 996-6582

2525 S Michigan Ave
Chicago, IL 60616
Phone (312) 355-1153

1740 W Taylor St
Ste 1400
Chicago, IL 60612
Phone (312) 996-3900

1855 W Taylor St
#3138
Chicago, IL 60612
Phone (312) 996-9120

Organizations & group practices 4

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": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1528229440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 W TAYLOR ST # 3.138",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127242",
            "telephone_number": "312-996-9120",
            "fax_number": "312-996-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 W TAYLOR ST # 3.138",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127242",
            "telephone_number": "312-996-9120",
            "fax_number": "312-996-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACINTOSH",
        "first_name": "PETER",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125054224",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036127245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.