Jasper A Petrucci, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

036-109437 Issued in IL

Practice address

2525 Kaneville Rd
Geneva, IL 60134-2578

Phone

(630) 584-1400

Fax

(630) 584-1733

NPI assigned

Jan 30, 2006

Last updated

Dec 28, 2021By the provider in NPPES

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 3

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

Merit-based Incentive Payment System (MIPS)

Final score

81.69 of 100Reported as group

Quality

74.66

Promoting interoperability

100

Improvement activities

40

Cost

64.3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jasper.petrucci.1@26750.direct.athenahealth.com

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.

• Fox Valley Orthopaedic Associates, PLLC

  • Orthopaedic Surgery Physician
  • Geneva, IL
  • NPI 1295706851
  Medicare reassignment NPD
• Fox Valley Orthopaedic Associates, PLLC

  dba Fox Valley Orthopaedic Ambulatory Surgical Center

  • Ambulatory Surgical Clinic/Center
  • Geneva, IL
  • NPI 1104897644
  NPD
• Fox Valley Orthopaedic Associates, S.C.

  • Orthopaedic Surgery Physician
  • Elgin, IL
  • NPI 1689212623
  NPD

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1659342343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 KANEVILLE RD",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342578",
            "telephone_number": "630-584-1400",
            "fax_number": "630-584-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 KANEVILLE RD",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342578",
            "telephone_number": "630-584-1400",
            "fax_number": "630-584-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUCCI",
        "first_name": "JASPER",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036-109437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036109437",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00185930",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD GROUP",
            "identifier": "CF2064",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpetrucci288413@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1975 Lin Lor Lane, Plaza Suite",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60123",
            "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": "1975 Lin Lor Lane, Plaza Suite",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kevin Michael Pennington, ATC
• Performance Spine & Sport LLC
• Performance Spine and Sport Holdings LLC
• Joseph M Persak, M.D.
• Jennifer Lynn Peterson, APRN
• Timothy S Petsche, M.D.
• Mark J Pettinger, RPH
• Tegan Pfortmiller
• Candace Martin Phelan, LCPC
• Binu Philip, M.D.

• Orthopaedic Surgery Physician in Geneva, IL
• Providers in Geneva, 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 28, 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.