Individual provider Active NPI

Shane Jay Nho, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Chicago, IL
National Provider Identifier
1669649158
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
036-120601 Issued in IL
Practice address
1611 W Harrison St
Ste 400
Chicago, IL 60612-3841
Phone
(312) 243-4244
Fax
(312) 942-1517
NPI assigned
May 13, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 036-120601 IL Primary

Addresses

Primary practice location

1611 W Harrison St
Ste 400
Chicago, IL 60612-3841

Mailing address

1 Westbrook Corporate Ctr
#240
Westchester, IL 60154-5701
Phone (708) 236-2673

Other identifiers 1

IdentifierTypeStateIssuer
# 1633878OtherILBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080808000440 IL Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 2466526413 Reassigns benefits to 2 organizations
I20201117002476 IN Practitioner - Orthopedic Surgery 2466526413 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
Rush Medical College of Rush University, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthomidwest, PLLCGroup PAC ID 0749183713, 531 clinicians

Practice addresses (Care Compare)

1611 W Harrison St
Suite 400
Chicago, IL 60612-4861
Phone (877) 632-6637

9601 Calumet Ave
Munster, IN 46321-2871
Phone (877) 632-6637

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)26
Upper limb (arm) arthroscopy (minimally invasive joint repair)13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-120601ILMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomidwest, PLLC Sports Medicine CurrentSince Jul 1, 2022 Accepting new patients
Orthomidwest, PLLC CurrentSince Jul 1, 2022 Accepting new patients
Orthomidwest, PLLC CurrentSince Jul 1, 2022 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

1611 W Harrison St
Ste 400
Chicago, IL 60612
Phone (312) 243-4244

1611 W Harrison St
#400
Chicago, IL 60612
Phone (312) 243-4244

1611 W Harrison St
Chicago, IL 60612
Phone (312) 243-4244

963 N 129th Infantry Dr
Joliet, IL 60435
Phone (815) 725-8425

324 Roxbury Rd
Rockford, IL 61107
Phone (815) 381-7339

1 Westbrook Corporate Ctr
Ste 240
Westchester, IL 60154

9200 Calumet Ave
#300
Munster, IN 46321

9601 Calumet Ave
Munster, IN 46321
Phone (312) 432-2591

Interoperability endpoints

  • Direct secure messaging: shane.nho.1@12576.direct.athenahealth.com

Organizations & group practices 5

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": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1669649158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WESTBROOK CORPORATE CTR",
            "address_2": "#240",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601545701",
            "telephone_number": "708-236-2673",
            "fax_number": "708-492-5673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST",
            "address_2": "STE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123841",
            "telephone_number": "312-243-4244",
            "fax_number": "312-942-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NHO",
        "first_name": "SHANE",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-13",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IL",
            "license": "036-120601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "# 1633878",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.