Individual provider Active NPI

Timothy T Lantvit, DPM

  • Podiatrist
  • Northbrook, IL
National Provider Identifier
1720134422
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016004656 Issued in IL
Practice address
40 Skokie Blvd Ste 520
Northbrook, IL 60062-1601
Phone
(847) 504-5000
Fax
(847) 504-5015
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 07000775 IN
Podiatrist 213E00000X 016004656 IL Primary

Addresses

Primary practice location

40 Skokie Blvd Ste 520
Northbrook, IL 60062-1601

Mailing address

PO Box 917
Northbrook, IL 60065-0917
Phone (847) 504-5000

Other identifiers 7

IdentifierTypeStateIssuer
0732240001OtherDMERC # WITH PPG
200136470AMedicaidIN
P01770673OtherIARAILROAD MEDICARE
1720134422MedicaidIA
016004656MedicaidIL
480017047OtherILRAILRAOD MEDICARE
0002219563OtherILBCBS

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040913001162 IL Practitioner - Podiatry 1254308901 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quality Podiatry Group LTDGroup PAC ID 8325033400, 7 clinicians

Practice addresses (Care Compare)

10 Brookview Dr
Farmer City, IL 61842-9702
Phone (309) 928-2118

62 63Rd St
Willowbrook, IL 60527-2982
Phone (630) 887-9221

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
87.6
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue2345
Removal or shaving of skin growth936

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016004656ILMDPodiatrist
07000775INMDPodiatrist
00559IAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Podiatry Group, LTD Podiatrist CurrentSince Jan 1, 2022 Accepting new patients
Willowbrook Podiatry Inc Podiatrist CurrentSince Aug 1, 1994 Accepting new patients
Premiere Anesthesia Group LLC PastSince Aug 1, 1994 Accepting new patients
Preferred Podiatry Group PC Podiatrist Past Accepting new patients

Locations

7025 Beracasa Way
Ste 102G
Boca Raton, FL 33433
Phone (773) 321-2681

3354 Jerome Ln
East Saint Louis, IL 62206
Phone (618) 337-9400

2195 Foxglove Dr
Northbrook, IL 60062
Phone (847) 480-7110

105 E 23rd St
Sterling, IL 61081
Phone (815) 381-4264

62 63rd St
Willowbrook, IL 60527
Phone (630) 887-9221

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1720134422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600650917",
            "telephone_number": "847-504-5000",
            "fax_number": "847-504-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SKOKIE BLVD STE 520",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621601",
            "telephone_number": "847-504-5000",
            "fax_number": "847-504-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANTVIT",
        "first_name": "TIMOTHY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07000775",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016004656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC # WITH PPG",
            "identifier": "0732240001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200136470A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01770673",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720134422",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004656",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILRAOD MEDICARE",
            "identifier": "480017047",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0002219563",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.