Individual provider Active NPI

Thomas F Mientus, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Lake Forest, IL
National Provider Identifier
1649248824
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
036084906 Issued in IL
Practice address
660 N Westmoreland
Lake Forest Hospital
Lake Forest, IL 60045-1696
Phone
(847) 234-0049
Fax
(847) 234-1946
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036084906 IL Primary

Addresses

Primary practice location

660 N Westmoreland
Lake Forest Hospital
Lake Forest, IL 60045-1696

Mailing address

75 Remittance Dr
Ste 1895
Chicago, IL 60675-1895
Phone (847) 234-0049

Other identifiers 2

IdentifierTypeStateIssuer
220021761OtherILRR MCR
0360849066MedicaidIL

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
I20100722000338 IL Practitioner - Pathology 5597812925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Rush Medical College of Rush University, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Gastroenterology Group LLCGroup PAC ID 5193857423, 116 clinicians

Practice addresses (Care Compare)

1415 S Arlington Heights Rd
Arlington Heights, IL 60005-3765
Phone (847) 660-7755

1539 S Waukegan Rd
Waukegan, IL 60085-6727
Phone (847) 549-1312

745 Fletcher Dr
Suite 202
Elgin, IL 60123-4749
Phone (847) 888-1300

Merit-based Incentive Payment System (MIPS)

Final score
84.21 of 100Reported as group
Quality
67.65
Promoting interoperability
99
Improvement activities
40
Cost
80.55

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Gastroenterologists SC Current Accepting new patients
Illinois Gastroenterology Group, LLC Anatomic Pathology & Clinical Pathology CurrentSince Jun 1, 2010 Accepting new patients
Elgin Gastroenterology Endoscopy Center LLC Current Accepting new patients
Elgin Gastroenterology SC Current Accepting new patients
Consolidated Pathology Consultants, SC Past Accepting new patients
Consolidated Pathology Consultants SC Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

745 Fletcher Dr
Ste 202
Elgin, IL 60123
Phone (855) 483-7362

20 Tower Ct
Ste F
Gurnee, IL 60031
Phone (847) 662-9420

14052 W Petronella Dr
Ste 201
Libertyville, IL 60048
Phone (847) 549-1312

2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246

Organizations & group practices 6

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1649248824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 REMITTANCE DR",
            "address_2": "STE 1895",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606751895",
            "telephone_number": "847-234-0049",
            "fax_number": "847-234-1946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 N WESTMORELAND",
            "address_2": "LAKE FOREST HOSPITAL",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451696",
            "telephone_number": "847-234-0049",
            "fax_number": "847-234-1946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIENTUS",
        "first_name": "THOMAS",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036084906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "220021761",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360849066",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

Verify at the official NPI Registry.