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DR. ETAN P SUGARMAN M.D.
NPI 1235426610
Orthopaedic Surgery in Des Plaines, IL

Active since July 06, 2011PECOS EnrolledAccepts Medicare Assignment
91.25/100
CMS Quality Rating
999 E TOUHY AVE STE 450, DES PLAINES, IL 60018(833) 872-4477(630) 323-5625 Get Directions Write a Review

NPPES record last updated: June 10, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 10, 2024, Mar 8, 2019 (2 updates tracked since 2019).

About Dr. Etan P Sugarman M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ETAN P SUGARMAN M.D. (NPI 1235426610) is an individual orthopaedic surgery provider in Des Plaines, Illinois, licensed in Illinois (036.168642) and active in the NPI registry since July 2011. He is enrolled in Medicare PECOS, is affiliated with Northwestern Medicine Central Dupage Hospital, and maintains a secondary practice location in New York.

NPPES Registry Identity

NPI1235426610
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. ETAN P SUGARMANCredential: M.D.
Location Address999 E TOUHY AVE STE 450Des Plaines, IL 60018-2748
Mailing Address999 E Touhy Ave Ste 450Des Plaines, IL 60018-2748 · (833) 872-4477 · Fax (630) 323-5625
Phone(833) 872-4477
Fax(630) 323-5625
Sole ProprietorYes
Medical School CMSAlbert Einstein College Of Medicine Of Yeshiva UniversityGraduated 2011
Enumeration DateJuly 6, 2011
Last NPPES UpdateJune 10, 20242 updates tracked since enumeration
NPPES CertifiedJune 10, 2024
✔ NPI 1235426610 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Licenses✔ Licensed in IL · 036.168642✔ Licensed in NY · 289302
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
999 E TOUHY AVE STE 450, Des Plaines, IL 60018
Open in Google Maps ↗

Secondary Practice Location 1

Location 1200 West 13th Street, 6th FloorNew York, NY 10011 · Phone (646) 665-6784 · Fax (646) 665-6791

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Etan P Sugarman M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID244526994
PECOS Enrollment IDI20240417002663, I20240501001036, I20240520002552
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Etan Sugarman reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

American Hip Institute, LLC
Same address
Sports Medicine
999 E TOUHY AVE, SUITE 450
Des Plaines, IL 60018
  • Reassigned Medicare billing, Illinois, Indiana and Wisconsin enrollments
  • 29 clinicians in this Medicare group
NPI 1285101808 (630) 920-2317
North Shore-Lij Medical PC
741 mi
Urology
1010 NORTHERN BLVD STE 110
Great Neck, NY 11021
  • Reassigned Medicare billing, New York enrollment
  • 9,353 clinicians in this Medicare group
NPI 1053688572 (516) 321-7400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
93 services13 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
46 services37 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
26 services26 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
23 services16 patients
X-ray of knee, 4 or more views 73564
An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.
14 services12 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
12 services12 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northwestern Medicine Central Dupage Hospital

Acute Care Hospitals · Winfield, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140242
Location25 North Winfield RoadWinfield, IL 60190 · Du Page County
Emergency services Birthing friendly

St Alexius Medical Center

Acute Care Hospitals · Hoffman Estates, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140290
Location1555 N Barrington RdHoffman Estates, IL 60169 · Cook County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60018 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

91.25/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality74.92
Promoting Interoperability91.67
Improvement Activities40

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ABIGAIL ROBERTS PA-C
Physician Assistant
999 E TOUHY AVE STE 450
DES PLAINES, IL 60018
Cook County (833) 872-4477
SARAH KAPOLNEK PA
Physician Assistant
999 E TOUHY AVE STE 450
DES PLAINES, IL 60018
Cook County (877) 342-0237
DR. BENJAMIN DOMB M.D.
Orthopaedic Surgery (Sports Medicine)
999 E TOUHY AVE STE 450
DES PLAINES, IL 60018
Cook County (630) 920-2323
ROGER ANDRES QUESADA JIMENEZ CSA
Specialist/Technologist, Other (Surgical Assistant)
999 E TOUHY AVE STE 450
DES PLAINES, IL 60018
Cook County (883) 872-4477
JULIA JEKLI DNP
Nurse Practitioner
999 E TOUHY AVE STE 450
DES PLAINES, IL 60018
Cook County (630) 920-2323
DARCY ANNE STACY STEEL APN, FNP-C
Nurse Practitioner (Family)
999 E TOUHY AVE STE 450
DES PLAINES, IL 60018
Cook County (630) 920-2323
DR. ADY HAIM KAHANA ROJKIND CSA
Specialist/Technologist, Other (Surgical Assistant)
999 E TOUHY AVE STE 450
DES PLAINES, IL 60018
Cook County (833) 872-4477
PAYAM SABETIAN CSA
Specialist/Technologist, Other (Surgical Assistant)
999 E TOUHY AVE STE 450
DES PLAINES, IL 60018
Cook County (883) 872-4477

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Etan Sugarman's NPI number?

The NPI number for Etan Sugarman is 1235426610. It was assigned to this individual provider in the NPPES registry on July 6, 2011.

Where is Etan Sugarman located?

Etan Sugarman practices at 999 E Touhy Ave Ste 450, Des Plaines, IL 60018. The listed phone number is (833) 872-4477.

What is Etan Sugarman's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Etan Sugarman enrolled in Medicare?

Yes. Etan Sugarman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Etan Sugarman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Etan Sugarman reassigns Medicare benefits to 2 organizations: American Hip Institute, LLC (Des Plaines, IL) and North Shore-Lij Medical PC (Great Neck, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Etan Sugarman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Etan Sugarman affiliated with any hospitals?

According to CMS data, Etan Sugarman is affiliated with Northwestern Medicine Central Dupage Hospital and St Alexius Medical Center.

When was this NPI record last updated?

The NPPES record for Etan Sugarman was last updated on June 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.