Individual provider Active NPI

Kenneth Ridge Macek, M. D.

  • Obstetrics & Gynecology Physician
  • Warrenville, IL
National Provider Identifier
1902028293
Registry record updated Feb 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036-117591 Issued in IL
Practice address
28375 Davis Pkwy
Suite 901
Warrenville, IL 60555-3030
Phone
(630) 653-4240
Fax
(630) 255-4034
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036-117591 IL Primary

Addresses

Primary practice location

28375 Davis Pkwy
Suite 901
Warrenville, IL 60555-3030

Mailing address

28375 Davis Pkwy
Suite 901
Warrenville, IL 60555-3030
Phone (630) 653-4240

Other identifiers 4

IdentifierTypeStateIssuer
206147213OtherILMEDICARE PTAN (INDIVIDUAL)
P01258413OtherILMEDICARE RAILROAD (INDIVIDUAL)
036117591MedicaidIL
CA4748OtherILMEDICARE RAILROAD (GROUP)

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
I20070728000268 IL Practitioner - Obstetrics/Gynecology 1850492281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Loyola University of Chicago, Stritch School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

28375 Davis Pkwy
Warrenville, IL 60555-3030
Phone (630) 653-4240

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-117591ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Dec 1, 2012 Accepting new patients
Central Dupage Physician Group CurrentSince Dec 1, 2012 Accepting new patients
Dupage Obstetrics and Gynecology, S.C. Obstetrics & Gynecology Past Accepting new patients

Locations

820 S State Route 59
Bartlett, IL 60103
Phone (630) 213-9600

Dept 5777
Carol Stream, IL 60122

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

351 Delnor Dr
Ste 207
Geneva, IL 60134
Phone (331) 732-4600

636 Raymond Dr
Ste 303
Naperville, IL 60563
Phone (630) 357-6540

28375 Davis Pkwy
Warrenville, IL 60555
Phone (630) 225-4060

28375 Davis Pkwy
Ste 901
Warrenville, IL 60555

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

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 3

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392681600000",
    "number": "1902028293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28375 DAVIS PKWY",
            "address_2": "SUITE 901",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553030",
            "telephone_number": "630-653-4240",
            "fax_number": "630-255-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28375 DAVIS PKWY",
            "address_2": "SUITE 901",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553030",
            "telephone_number": "630-653-4240",
            "fax_number": "630-255-4034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACEK",
        "first_name": "KENNETH",
        "middle_name": "RIDGE",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2014-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-117591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "206147213",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD (INDIVIDUAL)",
            "identifier": "P01258413",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036117591",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD (GROUP)",
            "identifier": "CA4748",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenville, IL

Sources for this page

Verify at the official NPI Registry.