NPIMap

Organization Active NPI

Northshore Surgical Associates

Doing business as Synergy Medical Group

  • Surgical Physician Assistant
  • Saunemin, IL
National Provider Identifier
1942656657
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Legal business name
NORTHSHORE SURGICAL ASSOCIATES
Doing business as
Synergy Medical Group
Practice address
14970 N 2900 East Rd
Saunemin, IL 61769-6079
Phone
(815) 990-9525
NPI assigned
May 11, 2016
Last updated
Oct 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Authorized official

Name
Brian T Crowe, SA-CNPI 1154580116
Title
President
Phone
(815) 990-9525

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 238.000084 IL
Surgical Physician Assistant 363AS0400X NU Primary

Addresses

Primary practice location

14970 N 2900 East Rd
Saunemin, IL 61769-6079

Mailing address

14970 N 2900 East Rd
Saunemin, IL 61769-6079
Phone (815) 990-9525

Other names 1

  • Synergy Medical Group Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1942656657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14970 N 2900 EAST RD",
            "city": "SAUNEMIN",
            "state": "IL",
            "postal_code": "617696079",
            "telephone_number": "815-990-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14970 N 2900 EAST RD",
            "city": "SAUNEMIN",
            "state": "IL",
            "postal_code": "617696079",
            "telephone_number": "815-990-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-11",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "CROWE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-990-9525",
        "authorized_official_credential": "SA-C"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "238.000084",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Synergy Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Synergy Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saunemin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.