Individual provider Active NPI

Stephen David Pesanti, M.D.

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1578826921
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036-143917 Issued in IL
Practice address
912 S Wood St
Chicago, IL 60612-4300
Phone
(123) 456-7890
NPI assigned
Jun 20, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036-143917 IL Primary

Addresses

Primary practice location

912 S Wood St
Chicago, IL 60612-4300

Mailing address

912 S Wood St
Chicago, IL 60612-4300

Other practice location 1

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-2200

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
I20171030003370 IL Practitioner - Psychiatry 6507145356 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

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
036-143917ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County Psychiatry CurrentSince Oct 12, 2023 Accepting new patients
The Board of Trustees of the University of Illinois Psychiatry CurrentSince Sep 10, 2017 Accepting new patients
Cook County CurrentSince Oct 12, 2023 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Sep 10, 2017 Accepting new patients
Cook County Current Accepting new patients
Uhs of Hartgrove, Inc. Psychiatry Current Accepting new patients
Uhs of Hartgrove, Inc Psychiatry CurrentSince Nov 1, 2024 Accepting new patients
The Board of Trustees of the University of Illinois Past Accepting new patients

Locations

7825 Solution Ctr
Chicago, IL 60677

835 S Wolcott Ave
Rm W140
Chicago, IL 60612

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

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

912 S Wood St
Chicago, IL 60612
Phone (312) 996-2200

5730 W Roosevelt Rd
Chicago, IL 60644
Phone (773) 413-1700

Organizations & group practices 8

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": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1578826921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 S WOOD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 S WOOD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124300",
            "telephone_number": "123-456-7890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9500 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441950001",
            "country_code": "US",
            "telephone_number": "216-444-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PESANTI",
        "first_name": "STEPHEN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-143917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.