Timothy J. Gray (NPI# 1215984752, PAC ID# 1759411507) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1215984752 |
| PAC ID by PECOS | 1759411507 |
| Professional Enrollment ID | I20100604001010 |
| Full Name | Timothy J. Gray |
| Organization Legal Name | BONUTTI ORTHOPEDIC SERVICES LTD |
| Address |
1303 W Evergreen Ave Effingham IL 62401-1638 |
| Phone Number | 21734234002414 |
| Gender | M |
| Medical School | UNIVERSITY OF ILLINOIS AT CHICAGO HEALTH SCIENCE CENTER |
| Graduation Year | 1988 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Group Practice PAC ID | 7012985328 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140032 | ST ANTHONYS MEMORIAL HOSPITAL |
| 141351 | CLAY COUNTY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1303 W Evergreen Ave, Effingham, IL 62401-1638 | 21734234002414 | BONUTTI ORTHOPEDIC SERVICES LTD |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | BONUTTI ORTHOPEDIC SERVICES LTD |
| Physicians | 8 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Frank S Lee | Orthopedic Surgery | Bonutti Orthopedic Services Ltd | 1303 W Evergreen Ave, Effingham, IL 62401-1638 |
| Joseph M Ajdinovich | Orthopedic Surgery | Bonutti Orthopedic Services Ltd | 1303 W Evergreen Ave, Effingham, IL 62401-1638 |
| Thomas L Williams | Physician Assistant | Bonutti Orthopedic Services Ltd | 1303 W Evergreen Ave, Effingham, IL 62401-1638 |
| Didi E Omiyi | Orthopedic Surgery | Bonutti Orthopedic Services Ltd | 1303 W Evergreen Ave, Effingham, IL 62401-1638 |
| Nickolas Allen Williams | Physician Assistant | Bonutti Orthopedic Services Ltd | 1000 Health Ctr Dr, Mattoon, IL 61938-9253 |
| Jennifer Jean Hess | Nurse Practitioner | Bonutti Orthopedic Services Ltd | 1303 W Evergreen Ave, Effingham, IL 62401-1638 |
| Karl S. Rudert | Emergency Medicine | Bonutti Orthopedic Services Ltd | 1303 W Evergreen Ave, Suite 101, Effingham, IL 62401-1619 |
| Street Address |
1303 W EVERGREEN AVE |
| City | EFFINGHAM |
| State | IL |
| Zip | 62401-1638 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Frank S Lee | Orthopedic Surgery | Bonutti Orthopedic Services Ltd | 1303 W Evergreen Ave, Effingham, IL 62401-1638 |
| Joseph M Ajdinovich | Orthopedic Surgery | Bonutti Orthopedic Services Ltd | 1303 W Evergreen Ave, Effingham, IL 62401-1638 |
| Thomas L Williams | Physician Assistant | Bonutti Orthopedic Services Ltd | 1303 W Evergreen Ave, Effingham, IL 62401-1638 |
| Didi E Omiyi | Orthopedic Surgery | Bonutti Orthopedic Services Ltd | 1303 W Evergreen Ave, Effingham, IL 62401-1638 |
| Jennifer Jean Hess | Nurse Practitioner | Bonutti Orthopedic Services Ltd | 1303 W Evergreen Ave, Effingham, IL 62401-1638 |
| Karl S. Rudert | Emergency Medicine | Bonutti Orthopedic Services Ltd | 1303 W Evergreen Ave, Suite 101, Effingham, IL 62401-1619 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Paul G Rhodes | Chiropractic | 200 E Fayette Ave, Effingham, IL 62401-0022 | |
| Lenora M Drees | Nurse Practitioner | Family Care Associates of Effingham, S.c. | 1106 N Merchant St Po Box, Suite 665, Effingham, IL 62401-0665 |
| P Dharmadev D Nayak | Urology | Effingham Urology Associates Sc | 414 W Virginia Ave, Effingham, IL 62401-1169 |
| Angela D Yocom | Nurse Practitioner | Effingham Urology Associates Sc | 414 W Virginia Ave, Effingham, IL 62401-1169 |
| Alicia J Davis | Nurse Practitioner | Effingham Urology Associates Sc | 414 W Virginia Ave, Effingham, IL 62401-1169 |
| Christopher P Weber | Optometry | Weber Optiks Inc | 1301 W Evergreen Ave, Suite B, Effingham, IL 62401-1634 |
| Anthony R Weber | Optometry | Weber Optiks Inc | 1301 W Evergreen Ave, Suite B, Effingham, IL 62401-1634 |
| Jeffrey W Whightsel | Obstetrics/gynecology | Effingham Obstetrics and Gynecology Associates LLC | 912 N Henrietta St, Effingham, IL 62401-1788 |
| Jennifer Dust | Obstetrics/gynecology | Effingham Obstetrics and Gynecology Associates LLC | 912 N Henrietta St, Effingham, IL 62401-1788 |
| Steven J Sparenberg | Family Medicine | Carle Health Care Incorporated | 912 N Henrietta St, Effingham, IL 62401-1788 |
| Find all physicians in zip 62401 | |||
| City | EFFINGHAM |
| Zip Code | 62401 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | EFFINGHAM + ORTHOPEDIC SURGERY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.