Individual provider Active NPI

Mary D Degroot, DPM

  • Podiatrist
  • New Lenox, IL
National Provider Identifier
1720071970
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016005141 Issued in IL
Practice address
1938 E Lincoln Hwy
Suite 206
New Lenox, IL 60451-3810
Phone
(815) 462-9225
Fax
(815) 462-5385
NPI assigned
Aug 23, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016005141 IL Primary

Addresses

Primary practice location

1938 E Lincoln Hwy
Suite 206
New Lenox, IL 60451-3810

Mailing address

1938 E Lincoln Hwy
Suite 206
New Lenox, IL 60451-3810
Phone (815) 462-9225

Other identifiers 3

IdentifierTypeStateIssuer
P00194730OtherILRAILROAD MEDICARE
01634686OtherILBCBS
016005141MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NV, MO3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20041021000429 IL Practitioner - Podiatry 7416918644 Reassigns benefits to 2 organizations
I20220405002099 NV Practitioner - Podiatry 7416918644 Reassigns benefits to 1 organization
I20230912002091 MO Practitioner - Podiatry 7416918644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitae Health Medical Illinois, PLLCGroup PAC ID 2365798410, 214 clinicians

Practice addresses (Care Compare)

611 Allen LN
Saint Charles, IL 60174-1355
Phone (630) 377-2211

Merit-based Incentive Payment System (MIPS)

Final score
87.82 of 100Reported as group
Quality
72.99
Improvement activities
40
Cost
75.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue4222
Removal or shaving of skin growth766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Podiatry Group PC Podiatrist CurrentSince Sep 1, 2023 Accepting new patients
Vitae Health Medical Illinois, PLLC CurrentSince Jan 1, 2025 Accepting new patients
Preferred Podiatry Group of Michigan PC Podiatrist CurrentSince Mar 1, 2022 Accepting new patients

Locations

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

701 Shadwell Ave
Flora, IL 62839
Phone (618) 662-8361

1201 N Alton St
Lebanon, IL 62254
Phone (618) 537-4401

5 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 242-1064

3450 Oakton St
Ste 300
Skokie, IL 60076

611 Allen Ln
St Charles, IL 60174
Phone (630) 377-2211

1000 Patterson St
Anderson, MO 64831
Phone (417) 845-3351

3000 NE 64th St
Kansas City, MO 64119
Phone (816) 393-6762

5650 S Rainbow Blvd
Las Vegas, NV 89118
Phone (702) 470-1102

Organizations & group practices 4

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296000000000",
    "number": "1720071970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1938 E LINCOLN HWY",
            "address_2": "SUITE 206",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604513810",
            "telephone_number": "815-462-9225",
            "fax_number": "815-462-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1938 E LINCOLN HWY",
            "address_2": "SUITE 206",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604513810",
            "telephone_number": "815-462-9225",
            "fax_number": "815-462-5385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGROOT",
        "first_name": "MARY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-23",
        "last_updated": "2011-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016005141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00194730",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01634686",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016005141",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

Verify at the official NPI Registry.