Individual provider Active NPI

Peter Burton Pruitt, M.D.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1831465749
Registry record updated May 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036140183 Issued in IL
Practice address
680 N Lake Shore Dr
Suite 1000
Chicago, IL 60611-4546
Phone
(312) 695-0665
NPI assigned
Mar 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036140183 IL Primary

Addresses

Primary practice location

680 N Lake Shore Dr
Suite 1000
Chicago, IL 60611-4546

Mailing address

680 N Lake Shore Dr
Suite 1000
Chicago, IL 60611-4546
Phone (312) 695-0665

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
I20160609001203 IL Practitioner - Emergency Medicine 6901058957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Maryland School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

680 N Lake Shore Dr
Suite 810
Chicago, IL 60611-8700
Phone (312) 926-6146

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036140183ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2016 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2016 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

680 N Lake Shore Dr
Ste 810
Chicago, IL 60611
Phone (312) 926-8811

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

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 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": "1332633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1831465749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "SUITE 1000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-695-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "SUITE 1000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-695-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "PETER",
        "middle_name": "BURTON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-25",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036140183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.