NPIMap

Individual provider Active NPI

Jason C Popp, MD

  • Family Medicine Physician
  • Rochelle, IL
National Provider Identifier
1003993148
Registry record updated Apr 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036104525 Issued in IL
Practice address
900 N 2ND St
Suite 200
Rochelle, IL 61068-1717
Phone
(815) 562-3784
Fax
(815) 561-3142
NPI assigned
Nov 1, 2006
Last updated
Apr 29, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036104525 IL Primary

Addresses

Primary practice location

900 N 2ND St
Suite 200
Rochelle, IL 61068-1717

Mailing address

900 N 2ND St
Suite 200
Rochelle, IL 61068-1717
Phone (815) 562-3784

Other identifiers 1

IdentifierTypeStateIssuer
036104525MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091229000359 IL Practitioner - Family Practice 8729128541 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochelle Community Hospital AssociationGroup PAC ID 4789581828, shared by 3 NPIs, 27 clinicians

Practice addresses (Care Compare)

900 N 2ND St
Suite 200
Rochelle, IL 61068-1717
Phone (815) 562-3784

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036104525ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rochelle Community Hospital Association CurrentSince Oct 22, 2001 Accepting new patients
Rochelle Community Hospital Association Family Medicine Current Accepting new patients
Rochelle Community Hospital Association CurrentSince Oct 22, 2001 Accepting new patients

Locations

510 Lincoln Hwy
Rochelle, IL 61068
Phone (815) 561-8335

900 N 2nd St
Rochelle, IL 61068
Phone (815) 562-2181

900 N 2nd St
Ste 200
Rochelle, IL 61068
Phone (815) 562-2181

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rochelle Community HospitalRochelle, IL, CCN 141312 Hospital Corporate Director
W-2 Managing Employee		 May 26, 2020
May 26, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461888000000",
    "number": "1003993148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N 2ND ST",
            "address_2": "SUITE 200",
            "city": "ROCHELLE",
            "state": "IL",
            "postal_code": "610681717",
            "telephone_number": "815-562-3784",
            "fax_number": "815-561-3142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N 2ND ST",
            "address_2": "SUITE 200",
            "city": "ROCHELLE",
            "state": "IL",
            "postal_code": "610681717",
            "telephone_number": "815-562-3784",
            "fax_number": "815-561-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPP",
        "first_name": "JASON",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2016-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036104525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036104525",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochelle, IL

Sources for this page

Verify at the official NPI Registry.