Jacqueline Marie Gowan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

125.073515 Issued in IL

Practice address

1501 S California Ave Ste L1026
Chicago, IL 60608-1732

Phone

(773) 257-6097

NPI assigned

Jun 30, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Merit-based Incentive Payment System (MIPS)

Final score

94.03 of 100Reported as group

Quality

71.53

Promoting interoperability

100

Improvement activities

40

Cost

76.89

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Mount Sinai Community Foundation

  • Rehabilitation Hospital
  • Chicago, IL
  • NPI 1376715896
  Medicare reassignment NPD
• Mount Sinai Community Foundation

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1982657854
  NPD
• Mount Sinai Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1871927053
  NPD (past)

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

{
    "created_epoch": "1561852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561852800000",
    "number": "1003478058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S CALIFORNIA AVE STE L1026",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081732",
            "telephone_number": "773-257-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S CALIFORNIA AVE STE L1026",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081732",
            "telephone_number": "773-257-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOWAN",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-30",
        "last_updated": "2019-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.073515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vidya Govind, MD
• Nivash Govindan, MD
• Geetha Govindarajan, M.D., PH.D., M.P.H
• Monika Magdalena Govoni, DDS
• Robert Anthony Govoni, DDS
• Geetha Gowda, MD
• Indraneel Gowdar, MD
• Brandi Gowder, DOULA
• Matthew Maurice Gowder
• Alexa Gowens

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.