Individual provider Active NPI

Gregg M. Menaker, MD

  • Dermatology Physician
  • Skokie, IL
National Provider Identifier
1639259641
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036103610 Issued in IL
Practice address
9977 Woods Dr
3Rd Floor
Skokie, IL 60077-1057
Phone
(847) 663-8062
Fax
(847) 663-1027
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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 036103610 IL Primary

Addresses

Primary practice location

9977 Woods Dr
3Rd Floor
Skokie, IL 60077-1057

Mailing address

2650 Ridge Ave
Evanston Hospital
Evanston, IL 60201-1718
Phone (847) 570-1644

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gmenaker14616@direct.northshore.org

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
I20050913000546 IL Practitioner - Dermatology 9234162033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

4901 Searle Pkwy
Suite 150
Skokie, IL 60077-1057

9977 Woods Dr
Skokie, IL 60077-1057
Phone (847) 663-8062

9977 Woods Dr 2ND Floor
Skokie, IL 60077-1057
Phone (847) 663-8370

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision243
Removal of skin lesions58
Removal of skin cancer1091
Skin biopsy23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036103610ILMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Jan 1, 2001 Accepting new patients
Endeavor Health Medical Group Dermatology CurrentSince Jan 1, 2001 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

9977 Woods Dr
Fl 3
Skokie, IL 60077
Phone (847) 663-8410

9933 Woods Dr
Ste 200
Skokie, IL 60077
Phone (847) 663-8060

9933 Woods Dr
Skokie, IL 60077
Phone (847) 663-8060

830 W End Ct
Ste 500
Vernon Hills, IL 60061
Phone (847) 522-8900

Interoperability endpoints

  • Direct secure messaging: gmenaker14616@direct.northshore.org

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 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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1639259641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "EVANSTON HOSPITAL",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-1644",
            "fax_number": "847-733-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR",
            "address_2": "3RD FLOOR",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "847-663-8062",
            "fax_number": "847-663-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENAKER",
        "first_name": "GREGG",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036103610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmenaker14616@direct.northshore.org",
            "affiliation": "N",
            "address_1": "9977 Woods Dr",
            "address_2": "3rd Floor",
            "city": "Skokie",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600771057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.