Individual provider Active NPI

Andrew P Geddes, MD

  • Pediatrics Physician
  • Rockford, IL
National Provider Identifier
1992807002
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036093633 Issued in IL
Practice address
3505 North Bell School Road
Rockford, IL 61114
Phone
(779) 696-0300
NPI assigned
Sep 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036093633 IL Primary

Addresses

Primary practice location

3505 North Bell School Road
Rockford, IL 61114

Mailing address

PO Box 78866
Milwaukee, WI 53278-8866
Phone (779) 696-7150

Other practice location 1

3775 N Mulford Rd
Rockford, IL 61114
Phone (779) 696-8400

Other identifiers 1

IdentifierTypeStateIssuer
036093633MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ageddesmd913442@direct.uwhealth.org

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
I20120419000751 IL Practitioner - Pediatric Medicine 2567623424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

3505 N Bell School Rd
Rockford, IL 61114-6624
Phone (779) 696-0300

3535 N Bell School Rd
Regional Cancer Center
Rockford, IL 61114-6624
Phone (779) 696-9400

6824 Newburg Rd
Sa Valley
Rockford, IL 61108-4330
Phone (779) 696-7610

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036093633ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedishamerican Hospital Pediatrics CurrentSince Dec 1, 2011 Accepting new patients
Swedishamerican Hospital Pediatrics Current Accepting new patients
Swedishamerican Hospital CurrentSince Dec 1, 2011 Accepting new patients

Locations

3775 N Mulford Rd
Rockford, IL 61114
Phone (779) 696-8400

3505 N Bell School Rd
Rockford, IL 61114
Phone (779) 696-0300

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

Interoperability endpoints

  • Direct secure messaging: kfabian1223906@direct.uwhealth.org
  • Direct secure messaging: ageddesmd913442@direct.uwhealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1992807002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78866",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532788866",
            "telephone_number": "779-696-7150",
            "fax_number": "779-696-7342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 NORTH BELL SCHOOL ROAD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61114",
            "telephone_number": "779-696-0300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3775 N Mulford Rd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "61114",
            "country_code": "US",
            "telephone_number": "779-696-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEDDES",
        "first_name": "ANDREW",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036093633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093633",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ageddesmd913442@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "3505 North Bell School Road",
            "city": "Rockford",
            "state": "IL",
            "country_code": "US",
            "postal_code": "61114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.