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Organization Active NPI

Orthomidwest, PLLC

  • Orthopaedic Surgery Physician
  • Rockford, IL
National Provider Identifier
1730136474
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOMIDWEST, PLLC
Practice address
324 Roxbury Rd
Rockford, IL 61107-5090
Phone
(815) 398-9491
Fax
(815) 381-7498
NPI assigned
May 28, 2006
Last updated
Jan 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Authorized official

Name
Mrs. Leslie A Elmer
Title
Credentialing Coordinator
Phone
(815) 381-7431

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Rheumatology Physician 207RR0500X NU
Orthopaedic Surgery Physician 207X00000X NU Primary
Orthopaedic Hand Surgery Physician 207XS0106X NU
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X NU
Orthopaedic Trauma Physician 207XX0801X NU
Physical Medicine & Rehabilitation Physician 208100000X NU
Podiatrist 213E00000X NU
Physical Therapist 225100000X NU
Orthopedic Physical Therapist 2251X0800X NU
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

324 Roxbury Rd
Rockford, IL 61107-5090

Mailing address

PO Box 735263
Chicago, IL 60673-5263
Phone (815) 398-9491

Other names 1

  • Rockford Orthopedic Associates, LTD Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI, IN4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20040128000533 IL Part B Supplier - Clinic/Group Practice 0749183713 Receives reassigned benefits from 700 practitioners
1 other NPI on this enrollment
Practice locations: Rockford, IL; Naperville, IL; Oak Brook, IL; Oak Park, IL; Orland Park, IL; Oswego, IL; Park Ridge, IL; River Grove, IL…
O20100930050684 IL DME Supplier - Multi-Specialty - Physician 0749183713 Practice locations: Rockford, IL
O20201005001247 WI Part B Supplier - Clinic/Group Practice 0749183713 Receives reassigned benefits from 50 practitioners
Practice locations: Beloit, WI; Pleasant Prairie, WI
O20220607001798 IN Part B Supplier - Clinic/Group Practice 0749183713 Receives reassigned benefits from 150 practitioners
Practice locations: Munster, IN

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1625 N Harlem Ave
Ste 2600
Chicago, IL 60707
Phone (887) 632-6637

610 S Maple Ave
Ste 1400
Oak Park, IL 60304
Phone (708) 383-0770

8319 Grand Ave
River Grove, IL 60171

2902 McFarland Rd
Ste 300
Rockford, IL 61107
Phone (815) 316-2100

330 E Main St
Rockton, IL 61072
Phone (815) 624-0235

9601 Calumet Ave
Munster, IN 46321
Phone (312) 432-2591

Practitioners & affiliated clinicians

Practitioners 741

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 741

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1730136474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735263",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735263",
            "telephone_number": "815-398-9491",
            "fax_number": "815-381-7489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075090",
            "telephone_number": "815-398-9491",
            "fax_number": "815-381-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOMIDWEST, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "ELMER",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "815-381-7431",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rockford Orthopedic Associates, LTD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.