Individual provider Active NPI

Michael Andrew Wood, D.P.M.

  • Podiatrist
  • Chicago, IL
National Provider Identifier
1740222694
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016004728 Issued in IL
Practice address
10528 S Ewing Ave
Chicago, IL 60617-6219
Phone
(773) 375-0791
Fax
(773) 734-2723
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 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 016004728 IL Primary

Addresses

Primary practice location

10528 S Ewing Ave
Chicago, IL 60617-6219

Mailing address

PO Box 49
Lansing, IL 60438-0049
Phone (708) 418-5551

Other identifiers 1

IdentifierTypeStateIssuer
40022238OtherILRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20070920000413 IL Practitioner - Podiatry 3476571746 Reassigns benefits to 1 organization
I20111121000524 IN Practitioner - Podiatry 3476571746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3224 Ridge Rd
Suite 101
Lansing, IL 60438-3191
Phone (708) 418-5551

701 Superior Ave
Suite E
Munster, IN 46321-4038
Phone (708) 418-5551

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue68
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016004728ILMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael a. Wood, D.P.M., P.C. CurrentSince Mar 14, 2001 Accepting new patients
Surgicore, Inc. PastSince Feb 9, 2010 Accepting new patients

Locations

10528 S Ewing Ave
Chicago, IL 60617
Phone (708) 375-0791

10547 S Ewing Ave
Chicago, IL 60617
Phone (773) 221-1690

3224 Ridge Rd
Lansing, IL 60438
Phone (708) 418-5551

3224 Ridge Rd
Ste 101
Lansing, IL 60438
Phone (708) 418-5551

5454 Hohman Ave
Hammond, IN 46320
Phone (219) 933-2077

701 Superior Ave
Ste E
Munster, IN 46321
Phone (219) 922-7159

Interoperability endpoints

  • Direct secure messaging: mwood64094@direct.franciscanalliance.org
  • Direct secure messaging: michaelwooddpmpc@mmaw.ssdirect.aprima.com

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1740222694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 49",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604380049",
            "telephone_number": "708-418-5551",
            "fax_number": "708-418-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10528 S EWING AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606176219",
            "telephone_number": "773-375-0791",
            "fax_number": "773-734-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016004728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "40022238",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.