Individual provider Active NPI

Aaron Tivnan Pelletier, MD

  • Plastic Surgery Physician
  • Zion, IL
National Provider Identifier
1689820425
Registry record updated Mar 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
036.120929 Issued in IL
Practice address
2520 Elisha Ave
Zion, IL 60099-2676
Phone
(847) 731-5513
NPI assigned
Aug 12, 2008
Last updated
Mar 6, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 036.120929 IL Primary

Addresses

Primary practice location

2520 Elisha Ave
Zion, IL 60099-2676

Mailing address

2520 Elisha Ave
Zion, IL 60099-2676
Phone (847) 931-5513

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
I20120619000013 IL Practitioner - Plastic and Reconstructive Surgery 6901060201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of North Carolina at Chapel Hill School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of Hope Medical Group of Illinois PLLCGroup PAC ID 3274446596, 129 clinicians

Practice addresses (Care Compare)

2520 Elisha Ave
Zion, IL 60099-2676
Phone (847) 872-4561

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.5 of 100Reported as group
Quality
74.24
Promoting interoperability
100
Improvement activities
40
Cost
66.56

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.120929ILMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City of Hope Medical Group of Illinois PLLC CurrentSince Jul 1, 2012 Accepting new patients

Locations

2361 Paysphere Cir
Chicago, IL 60674
Phone (847) 746-4358

2520 Elisha Ave
Zion, IL 60099
Phone (800) 322-9183

Interoperability endpoints

  • Direct secure messaging: apelletier145258@cityofhope.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1689820425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 ELISHA AVE",
            "city": "ZION",
            "state": "IL",
            "postal_code": "600992676",
            "telephone_number": "847-931-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 ELISHA AVE",
            "city": "ZION",
            "state": "IL",
            "postal_code": "600992676",
            "telephone_number": "847-731-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "AARON",
        "middle_name": "TIVNAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-12",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": "036.120929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zion, IL

Sources for this page

Verify at the official NPI Registry.