Individual provider Active NPI

Thomas Waddell Smith, MD

  • Surgical Oncology Physician
  • Chicago, IL
National Provider Identifier
1952729527
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
036144153 Issued in IL
Practice address
5140 N California Ave Ste 420
Chicago, IL 60625-3645
Phone
(773) 293-8878
Fax
(773) 293-8879
NPI assigned
Apr 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X 036144153 IL Primary

Addresses

Primary practice location

5140 N California Ave Ste 420
Chicago, IL 60625-3645

Mailing address

5140 N California Ave Ste 420
Chicago, IL 60625-3645
Phone (773) 293-8878

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
I20210820000784 IL Practitioner - Surgical OncologyPractitioner - General Surgery 0446551006 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
Northwestern University Feinberg Medical School, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2050 Pfingsten Rd
Glenview, IL 60026-1324

2650 Ridge Ave
Evanston, IL 60201-1700

2739 W Foster Ave
Chicago, IL 60625-3661
Phone (773) 878-8200

5140 N California
Suite G600
Chicago, IL 60625-3645
Phone (773) 989-3803

5140 N California Ave
Chicago, IL 60625-3645

5140 N California Ave
Suite 565
Chicago, IL 60625-1000
Phone (773) 293-8878

5145 N California
Hosps Suite 331
Chicago, IL 60625-3661
Phone (847) 570-2280

5145 N California Ave
Chicago, IL 60625-3661
Phone (773) 878-8200

9600 Gross Point Rd
Skokie, IL 60076-1214

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Current Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2021 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2021 Accepting new patients
Endeavor Health Medical Group CurrentSince Aug 30, 2022 Accepting new patients
Central Dupage Physician Group PastSince Aug 1, 2021 Accepting new patients
Swedish Covenant Management Services, Inc PastSince Sep 4, 2022 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

250 E Superior St
#32304
Chicago, IL 60611
Phone (208) 703-2139

5140 N California Ave
Chicago, IL 60625
Phone (773) 275-8811

250 E Superior St
Ste 42304
Chicago, IL 60611
Phone (312) 472-0436

9532 Eagle Way
Chicago, IL 60678

5140 N California Ave
Ste 465
Chicago, IL 60625
Phone (773) 271-4444

5140 N California Ave
Ste 420
Chicago, IL 60625
Phone (773) 293-8878

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

9650 Gross Point Rd
Ste 3900
Skokie, IL 60076
Phone (224) 251-2374

Organizations & group practices 6

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 2

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": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1952729527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 N CALIFORNIA AVE STE 420",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253645",
            "telephone_number": "773-293-8878",
            "fax_number": "773-293-8879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 N CALIFORNIA AVE STE 420",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253645",
            "telephone_number": "773-293-8878",
            "fax_number": "773-293-8879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "THOMAS",
        "middle_name": "WADDELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-01",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "IL",
            "license": "036144153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.