Individual provider Active NPI

Lucio A. Pavone, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Naperville, IL
National Provider Identifier
1790966844
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
036123223 Issued in IL
Practice address
120 Spalding Dr Ste 207
Naperville, IL 60540-6520
Phone
(630) 646-6020
Fax
(630) 646-6006
NPI assigned
Nov 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X A98219 CA
Plastic and Reconstructive Surgery Physician 2086S0122X 036123223 IL Primary

Addresses

Primary practice location

120 Spalding Dr Ste 207
Naperville, IL 60540-6520

Mailing address

120 Spalding Dr Ste 207
Naperville, IL 60540-6520
Phone (630) 646-6020

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lpavone84239@direct.edward.org Direct

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
I20101006000287 IL Practitioner - Plastic and Reconstructive Surgery 0547452708 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Albany Medical College of Union University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

120 Spalding Dr
Suite 205And207
Naperville, IL 60540-6508
Phone (630) 646-6020

1200 S York Rd
Suite 1120
Elmhurst, IL 60126-5626
Phone (630) 527-3200

1200 S York St
Elmhurst, IL 60126-5626
Phone (331) 221-6636

155 E Brush Hill Rd
Elmhurst, IL 60126-5658
Phone (331) 221-0096

177 E Brush Hill Rd
Elmhurst, IL 60126-5658
Phone (630) 646-6020

2650 Ridge Ave
Evanston, IL 60201-1700

801 S Washington St
Naperville, IL 60540-7430
Phone (630) 527-5197

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy28
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A98219CAMDPlastic and Reconstructive Surgery Physician
036123223ILMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Health Ventures CurrentSince Aug 22, 2016 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 6, 2023 Accepting new patients
Edward Health Ventures CurrentSince Aug 22, 2016 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

1200 S York St
Ste 4140
Elmhurst, IL 60126
Phone (331) 221-5708

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

120 Spalding Dr
Ste 205
Naperville, IL 60540
Phone (630) 527-5217

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

120 Spalding Dr
Naperville, IL 60540
Phone (630) 527-5575

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

120 Spalding Dr
Ste 207
Naperville, IL 60540
Phone (630) 527-2700

4201 Winfield Rd
Fl 3
Warrenville, IL 60555

Interoperability endpoints

  • Direct secure messaging: lpavone84239@direct.edward.org

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.

Hospital & facility affiliations 2

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": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1790966844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 SPALDING DR STE 207",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406520",
            "telephone_number": "630-646-6020",
            "fax_number": "630-646-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SPALDING DR STE 207",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406520",
            "telephone_number": "630-646-6020",
            "fax_number": "630-646-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVONE",
        "first_name": "LUCIO",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-16",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A98219",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "IL",
            "license": "036123223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lpavone84239@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "120 Spalding Dr Ste 207",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605406520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.