Individual provider Active NPI

Jeffrey Allen Grinblatt, MD

  • Internal Medicine Physician
  • Skokie, IL
National Provider Identifier
1679580039
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036081091 Issued in IL
Practice address
9669 Kenton Ave
Suite 203
Skokie, IL 60076-1266
Phone
(847) 677-0212
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036081091 IL Primary

Addresses

Primary practice location

9669 Kenton Ave
Suite 203
Skokie, IL 60076-1266

Mailing address

6148 N Monticello Ave
Chicago, IL 60659-1113
Phone (773) 539-0642

Other identifiers 2

IdentifierTypeStateIssuer
0031603918OtherILBLUE CROSS BLUE SHIELD
036081091MedicaidIL

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
I20100712000042 IL Practitioner - Internal Medicine 2264564228 Practice locations: Skokie, IL; Park Ridge, IL

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Northwestern University Feinberg Medical School, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9669 Kenton Ave
Suite 203
Skokie, IL 60076-1227
Phone (847) 677-0212

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.81 of 100Reported as individual
Quality
90.8
Promoting interoperability
100
Improvement activities
40
Cost
65.23

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036081091ILMDInternal Medicine Physician

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679580039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6148 N MONTICELLO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591113",
            "telephone_number": "773-539-0642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9669 KENTON AVE",
            "address_2": "SUITE 203",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761266",
            "telephone_number": "847-677-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINBLATT",
        "first_name": "JEFFREY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036081091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0031603918",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036081091",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.