NPIMap

Individual provider Active NPI

Ronald G Severino, MD

  • Family Medicine Physician
  • Wheaton, IL
National Provider Identifier
1932214186
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036098318 Issued in IL
Practice address
2001 S Wiesbrook Rd
Wheaton, IL 60189
Phone
(630) 614-4000
Fax
(630) 614-4048
NPI assigned
Aug 20, 2006
Last updated
Jun 29, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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 036098318 IL Primary

Addresses

Primary practice location

2001 S Wiesbrook Rd
Wheaton, IL 60189

Mailing address

2001 S Wiesbrook Rd
Wheaton, IL 60189-7813
Phone (630) 614-4000

Other identifiers 3

IdentifierTypeStateIssuer
P00208252OtherILRR MEDICARE (INDIVIDUAL)
036098318MedicaidIL
K00180OtherILMEDICARE PTAN (INDIVIDUAL)

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
I20100423000415 IL Practitioner - Family Practice 7214064146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

2001 S Wiesbrook Rd
Wheaton, IL 60189-7813
Phone (630) 614-4000

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions34
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036098318ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Family Medicine CurrentSince Jul 1, 2018 Accepting new patients
Central Dupage Physician Group CurrentSince Jul 1, 2018 Accepting new patients
CGH Medical Center Past Accepting new patients
Rock River Health, Inc. Family Medicine Past Accepting new patients

Locations

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

Dept 5777
Carol Stream, IL 60122

351 Delnor Dr
Ste 300
Geneva, IL 60134
Phone (630) 262-1001

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

2001 N Gary Ave
Wheaton, IL 60187
Phone (630) 614-4100

2001 S Wiesbrook Rd
Wheaton, IL 60189
Phone (630) 510-7666

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Organizations & group practices 5

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 7

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1932214186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S WIESBROOK RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601897813",
            "telephone_number": "630-614-4000",
            "fax_number": "630-614-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S WIESBROOK RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "60189",
            "telephone_number": "630-614-4000",
            "fax_number": "630-614-4048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERINO",
        "first_name": "RONALD",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036098318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE (INDIVIDUAL)",
            "identifier": "P00208252",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098318",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "K00180",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.