Individual provider Active NPI

Monika D Kaniszewska, M.D.

  • Dermatology Physician
  • Lincolnshire, IL
National Provider Identifier
1598039711
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036.137366 Issued in IL
Practice address
275 Parkway Dr Ste 521
Lincolnshire, IL 60069-4344
Phone
(847) 459-6400
Fax
(847) 459-4610
NPI assigned
Mar 6, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 036.137366 IL Primary

Addresses

Primary practice location

275 Parkway Dr Ste 521
Lincolnshire, IL 60069-4344

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other practice location 1

716 Vernon Ave
Glencoe, IL 60022-1531
Phone (847) 459-6400

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
I20150706001039 IL Practitioner - Dermatology 2668784679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Rush Medical College of Rush University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

275 Pkwy Dr
Suite 521
Lincolnshire, IL 60069-4344
Phone (847) 459-6400

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions999
Removal or shaving of skin growth1-10
Skin biopsy250

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.137366ILMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. Dermatology CurrentSince Nov 8, 2023 Accepting new patients
Forefront Dermatology, S.C. Dermatology Current Accepting new patients
Forefront Dermatology, S.C. Dermatology CurrentSince Nov 8, 2023 Accepting new patients
Forefront Dermatology, S.C. Dermatology Past Accepting new patients
Forefront Dermatology, S.C. Dermatology Past Accepting new patients

Locations

2051 Plainfield Rd
Crest Hill, IL 60403
Phone (815) 730-9900

716 Vernon Ave
Glencoe, IL 60022
Phone (847) 459-6400

275 Parkway Dr
Ste 521
Lincolnshire, IL 60069
Phone (847) 459-6400

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

Interoperability endpoints

  • Direct secure messaging: mkaniszewska@directaddress.net

Organizations & group practices 5

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": "1330992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1598039711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 PARKWAY DR STE 521",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "600694344",
            "telephone_number": "847-459-6400",
            "fax_number": "847-459-4610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "716 Vernon Ave",
            "address_purpose": "LOCATION",
            "city": "Glencoe",
            "state": "IL",
            "postal_code": "600221531",
            "country_code": "US",
            "telephone_number": "847-459-6400",
            "fax_number": "847-461-2025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANISZEWSKA",
        "first_name": "MONIKA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-06",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036.137366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincolnshire, IL

Sources for this page

Verify at the official NPI Registry.