David Scott Pezen, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036-091039 Issued in IL

Practice address

360 W Butterfield Rd
Suite #240
Elmhurst, IL 60126-5068

Phone

(630) 833-3222

Fax

(630) 833-3277

NPI assigned

Sep 12, 2005

Last updated

May 19, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Dermatology

Education

George Washington University School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• David S. Pezen, M.D., S.C.

  • Dermatology Physician
  • Elmhurst, IL
  • NPI 1295992295
  Medicare reassignment NPD Authorized official
• Samantha B. Conrad M.D.S.C

  • Dermatology Physician
  • Elmhurst, IL
  • NPI 1821353673
  NPD

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1801881313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 W BUTTERFIELD RD",
            "address_2": "SUITE #240",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265068",
            "telephone_number": "630-833-3222",
            "fax_number": "630-833-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 W BUTTERFIELD RD",
            "address_2": "SUITE #240",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265068",
            "telephone_number": "630-833-3222",
            "fax_number": "630-833-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZEN",
        "first_name": "DAVID",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036-091039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Autumn Peterson
• Craig Neil Peterson, RPH
• Tamara L Petre
• Iryna Petriv, FNP-BC
• Shannon C. Pettit, MD
• Pharmacy Alternatives LLC
• Crystal Kalarithara Philip, FNP-BC
• Christina Maria Philippou, MS CCC-SLP
• Phillips Family Medical Center SC
• Ofelia Phillips, M.D.

• Dermatology Physician in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.