Bonnie Smith, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036150551 Issued in IL

Practice address

2355 S Western Ave
Chicago, IL 60608-3837

Phone

(732) 541-4007

Fax

(312) 829-6375

NPI assigned

May 18, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, TX2 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

Specialty

Family Practice

Education

Midwestern University, Chicago College of Osteopathic Med, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Zuni Indian HospitalGroup PAC ID 5698689644, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Zuni Comprehensive Community Health Center Hospital, Zuni, NM, CCN 320060

Merit-based Incentive Payment System (MIPS)

Final score

82.36 of 100Reported as group

Quality

87.45

Improvement activities

0

Cost

93.44

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Zuni Indian Hospital

  • General Acute Care Hospital
  • Zuni, NM
  • NPI 1497843734

  TX

  Medicare reassignment Care Compare group NPD
• PCC Community Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Oak Park, IL
  • NPI 1871516799
  Medicare reassignment NPD
• DHHS,PHS,Naihs, Gallup Indian Medical Center

  • General Acute Care Hospital
  • Gallup, NM
  • NPI 1225002322

  TX

  Medicare reassignment NPD
• PCC Community Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1134954506
  NPD

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1669829776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 W 21ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606084511",
            "telephone_number": "773-254-1400",
            "fax_number": "312-829-6375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606083837",
            "telephone_number": "732-541-4007",
            "fax_number": "312-829-6375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BONNIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036150551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ben Carlton Smith, MD
• Betty B. Smith, LCSW, BCD
• Billye Raye Smith, RN
• Blair Smith
• Blake Allen Smith, D.P.M.
• Brandon Smith, PHARMD.
• Breeona Smith, CADC
• Bridgett Julan Smith, RPH
• Bridgette Smith, M.D.
• Brittani A Smith, MD

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; 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.