SMG SOUTH STATE HEALTH CENTER
NPI 1366787012
Family Medicine in Chicago, IL
About Smg South State Health Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SMG SOUTH STATE HEALTH CENTER (NPI 1366787012) is a healthcare organization registered as a family medicine in Chicago, Illinois and active in the NPI registry since December 2012. The organization lists David Berkey, Vice President Physician Services, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Smg South State Health Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
644Medicare enrollment records show 644 clinicians reassign Medicare billing to Smg South State Health Center, which bills Medicare for the services they deliver. Of these, 390 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 51
Nearest to this location (20)
See all 644Chicago, IL 60637
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Smg South State Health Center's NPI number?
The NPI number for Smg South State Health Center is 1366787012. It was assigned to this organization in the NPPES registry on December 6, 2012.
Where is Smg South State Health Center located?
Smg South State Health Center is located at 5050 S State St, Chicago, IL 60609. The listed phone number is (773) 257-1110.
What is Smg South State Health Center's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Smg South State Health Center enrolled in Medicare?
Yes. Smg South State Health Center is registered in the Medicare PECOS enrollment system.
When is Smg South State Health Center's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Illinois, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Smg South State Health Center?
According to the CMS Revalidation Reassignment List (October 2026 release), 644 clinicians in 51 Medicare specialties reassign their Medicare billing to Smg South State Health Center. A 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 the clinician's services. The largest specialties are Nurse Practitioner (81), Internal Medicine (59) and Obstetrics/Gynecology (43). Of these, 390 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Smg South State Health Center was last updated on December 6, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Smg South State Health Center · NPI 1366787012
Family Medicine organization in Chicago, Illinois. Organization record, active in the CMS NPPES registry since December 6, 2012.
## Identity
- **NPI:** 1366787012 (Entity type: Organization)
- **Enumerated:** December 6, 2012
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** Yes (part of Mt Sinai Community Foundation Dba Sinia Medical Group)
- **Authorized official:** David Berkey, VICE PRESIDENT PHYSICIAN SERVICES
## Practice location
- **Address:** 5050 S STATE ST, Chicago, IL 60609-5302
- **Phone:** (773) 257-1110
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Illinois, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 644 clinicians in 51 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (81), Internal Medicine (59), Obstetrics/Gynecology (43); 390 practice within 10 miles; [full list](https://npiprofile.com/npi/1366787012/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 6, 2012
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Source: [NPI Profile](https://npiprofile.com/npi/1366787012) · Data from the CMS NPPES public registry.