Jeffrey Petrusek

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

036.155766 Issued in IL

Practice address

27790 W Highway 22 Ste 27
Barrington, IL 60010-2396

Phone

(847) 649-6000

Fax

(847) 649-6060

NPI assigned

Mar 28, 2016

Last updated

Dec 27, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 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

Otolaryngology

Education

Loyola University of Chicago, Stritch School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest ENT Alliance PLLCGroup PAC ID 5294276259, 97 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291
• Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
• Advocate Sherman Hospital Hospital, Elgin, IL, CCN 140030

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: jpetrusek310599@direct.myadvocateaurora.org

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.

• Midwest ENT Alliance PLLC

  • Otolaryngology Physician
  • Orland Park, IL
  • NPI 1588449458
  Medicare reassignment Care Compare group NPD
• Ear, Nose & Throat Care Center, LTD.

  dba Ear, Nose & Throat Care Center

  • Otolaryngology Physician
  • Barrington, IL
  • NPI 1962063776
  Medicare reassignment NPD
• Bastian Voice Institute, LLC

  • Otolaryngology Physician
  • Downers Grove, IL
  • NPI 1922122571
  NPD (past)

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

• Advocate Health and Hospitals Corporation

  dba Advocate Good Shepherd Hospital

  • General Acute Care Hospital
  • Barrington, IL
  • NPI 1447368071
  Care Compare affiliation
• Advocate Sherman Hospital

  • General Acute Care Hospital
  • Elgin, IL
  • NPI 1629026364
  Care Compare affiliation
• Northern Illinois Medical Center

  dba Centegra Hospital McHenry

  • General Acute Care Hospital
  • McHenry, IL
  • NPI 1982611281
  Care Compare affiliation
• Sherman Hospital

  • Skilled Nursing Facility
  • Elgin, IL
  • NPI 1275584302

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1639531759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27790 W HIGHWAY 22 STE 27",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600102396",
            "telephone_number": "847-649-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27790 W HIGHWAY 22 STE 27",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600102396",
            "telephone_number": "847-649-6000",
            "fax_number": "847-649-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUSEK",
        "first_name": "JEFFREY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-28",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036.155766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpetrusek310599@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "27790 W Highway 22 Ste 27",
            "city": "Barrington",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600102396",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "27790 W Highway 22 Ste 27",
            "city": "Barrington",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600102396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Daniel J Pesavento, M.D.
• Michelle Peter
• Melodi J Peters, R.D. LDN
• Annalise Peterson
• Matthew C. Peterson, MD
• David Phillips
• Richard L Phillips, M.D.
• Gayle Pichlik, RD, LDN
• Martha Ball Pignataro, CPNP
• Pillai & Ganesan PLLC

• Otolaryngology Physician in Barrington, IL
• Providers in Barrington, IL by specialty
• Otolaryngology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; 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.