Peter M. Bonutti, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

036078905 Issued in IL

Practice address

1303 W Evergreen Ave Ste 200
Effingham, IL 62401-1638

Phone

(217) 342-3400

Fax

(217) 342-3477

NPI assigned

May 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Orthopedic Surgery

Education

University of Cincinnati College of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sarah Bush Lincoln Health CenterGroup PAC ID 5092614867, 411 clinicians

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• LHC-Illinois Home Health Care Home health agency, Marion, IL, CCN 147716
• Mederi Caretenders Home health agency, Mount Vernon, IL, CCN 147251
• Sarah Bush Lincoln Health Center Hospital, Mattoon, IL, CCN 140189
• SSM Health St Mary'S Hospital -Centralia Hospital, Centralia, IL, CCN 140034
• Herrin Hospital Hospital, Herrin, IL, CCN 140011
• Decatur Memorial Hospital Hospital, Decatur, IL, CCN 140135

Merit-based Incentive Payment System (MIPS)

Final score

88.96 of 100Reported as apm

Quality

69.5

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Sarah Bush Lincoln Health Center

  • General Acute Care Hospital
  • Mattoon, IL
  • NPI 1669564662
  Medicare reassignment Care Compare group NPD
• Biomax Rehabilitation Services, Inc

  • Prosthetic/Orthotic Supplier
  • Effingham, IL
  • NPI 1821186578
  NPD
• Sarah Bush Lincoln Health Center

  • Rural Health Clinic/Center
  • Greenville, IL
  • NPI 1811858970
  NPD
• Sarah Bush Lincoln Health Center

  • Critical Access Hospital
  • Vandalia, IL
  • NPI 1912988734
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Crossroads Home Care Services, LLC

  • Home Health Agency
  • Mount Vernon, IL
  • NPI 1437138070
  Care Compare affiliation
• Decatur Memorial Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1548357973
  Care Compare affiliation
• LHCG Xxxvii, LLC

  • Home Health Agency
  • Marion, IL
  • NPI 1740527407
  Care Compare affiliation
• Sarah Bush Lincoln Health Center

  • General Acute Care Hospital
  • Mattoon, IL
  • NPI 1669564662
  Care Compare affiliation
• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Herrin, IL
  • NPI 1528158573
  Care Compare affiliation
• St Mary'S Hospital, Centralia, Illinois

  • General Acute Care Hospital
  • Centralia, IL
  • NPI 1083617245
  Care Compare affiliation

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1629021571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619380372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 W EVERGREEN AVE STE 200",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624011638",
            "telephone_number": "217-342-3400",
            "fax_number": "217-342-3477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "904 W Temple Ave",
            "address_purpose": "LOCATION",
            "city": "Effingham",
            "state": "IL",
            "postal_code": "624012178",
            "country_code": "US",
            "telephone_number": "217-342-1234",
            "fax_number": "217-342-1230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONUTTI",
        "first_name": "PETER",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036078905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "178970",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036078905",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elaine Marie Blievernicht
• Cynthia Lynn Bloemker, COTA/L
• Jacy Lyn Blunt
• Emily Schultz Boll, FNP-C
• Bonutti Orthopedic Services LTD
• Kevin Paul Borntreger, D.C.
• Rose Catherine Borries, MOTR/L
• Jay A Borum, D.C.
• Emily S. Boyajian, APN
• Ruben D Boyajian, MD

• Orthopaedic Surgery Physician in Effingham, IL
• Providers in Effingham, IL by specialty
• Orthopaedic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.