Individual provider Active NPI

Todd A Permut, MD

  • Anesthesiology Physician
  • Burr Ridge, IL
National Provider Identifier
1780749903
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
D80432 Issued in MD
Practice address
180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone
(773) 834-4064
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X D80432 MD Primary

Addresses

Primary practice location

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686

Mailing address

PO Box 64382
Baltimore, MD 21264-4382
Phone (410) 955-1677

Other identifiers 1

IdentifierTypeStateIssuer
036088080MedicaidIL

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
I20040908001001 IL Practitioner - Anesthesiology 6103892419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Wayne State University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rockford Anesthesiologists Associated LLCGroup PAC ID 5597668004, 62 clinicians

Practice addresses (Care Compare)

1401 E State St
Swedishamerican Hospital
Rockford, IL 61104-2315
Phone (815) 968-4400

Hospital & facility affiliations

  • Uw Health Hospital, Rockford, IL, CCN 140228

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Anesthesiologists Associated, L.L.C. Anesthesiology CurrentSince Sep 6, 2019 Accepting new patients
Rockford Anesthesiologists Associated, L.L.C. Past Accepting new patients
Sunset Coast Anesthesia Associates PC Anesthesiology Past Accepting new patients

Locations

2202 Harlem Rd
#200
Loves Park, IL 61111
Phone (815) 877-4848

1401 E State St
Rockford, IL 61104
Phone (815) 489-4267

Interoperability endpoints

  • Direct secure messaging: tpermutmd23183@uchospital.direct-ci.com

Organizations & group practices 3

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 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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1780749903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64382",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644382",
            "telephone_number": "410-955-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276686",
            "telephone_number": "773-834-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERMUT",
        "first_name": "TODD",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D80432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088080",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burr Ridge, IL

Sources for this page

Verify at the official NPI Registry.