JEFFREY PETRUSEK – Otolaryngology Physician, NPI 1639531759
Otolaryngology Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
488 OTOLARYNGOLOGY in IL
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Provider Addresses for JEFFREY PETRUSEK
2160, South 1st Avenue, Maywood, Proviso Township, Cook County, Illinois, 60153, United States
BUILDING 105 ROOM 1870
MAYWOOD, IL 601533328
Phone: (708) 216-1676
Fax: (708) 216-4834
Type: Mailing
27790 W HIGHWAY 22 STE 27
BARRINGTON, IL 600102396
Phone: (847) 649-6000
Fax: (847) 649-6060
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 47 Open Payments records for all available years, with a total value of $975.
Total Amount is formed as General ($975) + Research ($0) + Ownership ($0) = $975.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Optinose US, Inc. ($231).
Total Amount
$975
General + Research + Ownership
Payments
47
Total payment records
General Amount
$975
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Optinose US, Inc. | $231 |
| GENZYME CORPORATION | $100 |
| CSL Behring | $88 |
| Takeda Pharmaceuticals U.S.A., Inc. | $63 |
| AERIN MEDICAL INC. | $53 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-06-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210617002295 | I | Otolaryngology | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97530 | Therapy procedure using functional activities | 192 | 62 | $0 |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 163 | 58 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 116 | 90 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 94 | 94 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 92 | 79 | $0 |
Insurance plans in this area (ZIP 60153)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | IL | |
| O T O L A R Y N G O L O G Y | IL | |
| O T O L A R Y N G O L O G Y | IL | |
| Qualified Audiologist | IL | |
| O T O L A R Y N G O L O G Y | IL | |
| Qualified Audiologist | WA | |
| Nurse Practitioner | IL | |
| Qualified Audiologist | IL | |
| Qualified Audiologist | IL | |
| Qualified Audiologist | IL |
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