NPIMap

Individual provider Active NPI

Daniel A Gutstein, MD

  • Family Medicine Physician
  • Skokie, IL
National Provider Identifier
1851316434
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-109673 Issued in IL
Practice address
8170 McCormick Blvd Ste 190
Skokie, IL 60076-2961
Phone
(847) 626-4374
Fax
(847) 929-4266
NPI assigned
Jul 13, 2006
Last updated
Apr 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-109673 IL Primary

Addresses

Primary practice location

8170 McCormick Blvd Ste 190
Skokie, IL 60076-2961

Mailing address

8170 McCormick Blvd Ste 190
Skokie, IL 60076-2961
Phone (847) 626-4374

Other identifiers 1

IdentifierTypeStateIssuer
036109673MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bowtiedr@direct.practicefusion.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041015000507 IL Practitioner - Family Practice 2860452653 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vital Signs Wellness LLCGroup PAC ID 4183958978, 4 clinicians

Practice addresses (Care Compare)

Skokie, IL 60076
Phone (847) 626-4374

Schaumburg, IL 60194
Phone (847) 444-9038

2200 Golf Rd
Glenview, IL 60025-4903
Phone (847) 657-1500

3500 Sheridan Rd
Zion, IL 60099-4371
Phone (847) 872-1500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue50

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-109673ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vital Signs Wellness, LLC Family Medicine CurrentSince Oct 29, 2021 Accepting new patients
Medicall Physicians Group, LTD. Past Accepting new patients
VHS Acquisition Subsidiary Number 3 Inc Family Medicine Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1851316434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 MCCORMICK BLVD STE 190",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762961",
            "telephone_number": "847-626-4374",
            "fax_number": "847-929-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8170 MCCORMICK BLVD STE 190",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762961",
            "telephone_number": "847-626-4374",
            "fax_number": "847-929-4266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTSTEIN",
        "first_name": "DANIEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-109673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036109673",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bowtiedr@direct.practicefusion.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8170 McCormick Blvd Ste 190",
            "city": "Skokie",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600762961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.