Matthew David Phillips, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036171243 Issued in IL

Practice address

1950 N Harlem Ave
Elmwood Park, IL 60707-3717

Phone

(708) 453-6800

Fax

(708) 453-3235

NPI assigned

Apr 29, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

General Surgery

Education

Indiana University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tiesenga Surgical Associates SCGroup PAC ID 5597750901, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community First Medical Center Hospital, Chicago, IL, CCN 140251
• Amita Health Resurrection Medical Center Hospital, Chicago, IL, CCN 140117
• Kindred Hospital - Chicago Long-term care hospital, Northlake, IL, CCN 142008

Merit-based Incentive Payment System (MIPS)

Final score

97.6 of 100Reported as group

Quality

84.28

Promoting interoperability

98

Improvement activities

40

Cost

76.04

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: matthew.phillips.1@6699.direct.athenahealth.com
• Direct secure messaging: mphillips18667@uihealth.direct-ci.com
• FHIR API: https://api.platform.athenahealth.com/6699/brand/1/csg/1/fhir/r4

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.

• Tiesenga Surgical Associates, S.C.

  • Surgery Physician
  • Elmwood Park, IL
  • NPI 1801876586
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Community First Healthcare of Illinois, Inc

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1033214416
  Care Compare affiliation
• Kindred Chicago Northlake, LLC

  • Long Term Care Hospital
  • Northlake, IL
  • NPI 1508472804

  Long-term care hospital

  Care Compare affiliation
• Kindred Chicago Northlake, LLC

  • Long Term Care Hospital
  • Chicago, IL
  • NPI 1821604125

  Long-term care hospital

  Care Compare affiliation
• Resurrection Medical Center - Chicago LLC

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1811735228
  Care Compare affiliation

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1962066597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 N HARLEM AVE",
            "city": "ELMWOOD PARK",
            "state": "IL",
            "postal_code": "607073717",
            "telephone_number": "708-453-6800",
            "fax_number": "708-453-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 N HARLEM AVE",
            "city": "ELMWOOD PARK",
            "state": "IL",
            "postal_code": "607073717",
            "telephone_number": "708-453-6800",
            "fax_number": "708-453-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-29",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036171243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36171243",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Park Place Dental LLC
• Kyuhun Park
• Fred Henry Pasquesi, D.D.S.
• Deepa Cherla Patel, MD
• Adam Pepek, PHARMD
• Physiotherapy Associates Inc
• Seema Pillai, NP
• Cynthia Plazas, PH.D., LCPC
• Alicja B Poleszak, M.D.
• Anthony Orlando Ponzio, D.D.S

• Surgery Physician in Elmwood Park, IL
• Providers in Elmwood Park, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.