Individual provider Active NPI

Geoffrey Thomas Swanson, PA-C, ATC

  • Physician Assistant
  • Maywood, IL
National Provider Identifier
1902491418
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.008580 Issued in IL
Practice address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone
(888) 584-7888
NPI assigned
Mar 5, 2021
Last updated
Aug 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.008580 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153-3328

Mailing address

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-3834

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gswanson147554@direct.luhs.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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211122001140 IL Practitioner - Physician Assistant 7315336815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

1 S260 Summit Ave
Oakbrook Terrace, IL 60181-3941
Phone (630) 953-6600

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

300 N York Rd
Elmhurst, IL 60126-2318
Phone (630) 833-0630

6800 N Frontage Rd
Burr Ridge, IL 60527-7819
Phone (708) 327-1000

701 W N Ave
Melrose Park, IL 60160-1612
Phone (708) 681-3200

715 W N Ave
Melrose Park, IL 60160-1612
Phone (708) 450-4554

719 W N Ave
Melrose Park, IL 60160-1612
Phone (708) 538-6773

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.008580ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Dec 6, 2021 Accepting new patients
Loyola University Medical Center CurrentSince Dec 6, 2021 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

6800 N Frontage Rd
Burr Ridge, IL 60527
Phone (708) 327-1000

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

701 W North Ave
Melrose Park, IL 60160
Phone (708) 450-5779

1S260 Summit Ave
Oakbrook Terrace, IL 60181
Phone (630) 953-6600

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

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": "1614902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1902491418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-3834",
            "fax_number": "708-216-6223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "888-584-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "GEOFFREY",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "PA-C, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-05",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.008580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gswanson147554@direct.luhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.