Nicole Oluwabunmi Macaulay, M.D

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

036120392 Issued in IL

Practice address

5970 Churchview Dr
Rockford, IL 61107-2574

Phone

(815) 484-6398

Fax

(815) 395-2021

NPI assigned

Jan 17, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Specialty

Obstetrics/Gynecology

Education

Northwestern University Feinberg Medical School, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rockford Health PhysiciansGroup PAC ID 2567374036, 520 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Javon Bea Hospital Hospital, Rockford, IL, CCN 140239

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nmacaulay48641@direct.mhemail.org

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.

• Rockford Health Physicians

  dba Mercyhealth Physicians

  • Multi-Specialty Clinic/Center
  • Rockford, IL
  • NPI 1043242886
  Medicare reassignment Care Compare group NPD

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

• Javon Bea Hospital

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1629118609
  Care Compare affiliation

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1073799235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5970 CHURCHVIEW DRIVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61107",
            "telephone_number": "815-971-2000",
            "fax_number": "815-395-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5970 CHURCHVIEW DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611072574",
            "telephone_number": "815-484-6398",
            "fax_number": "815-395-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACAULAY",
        "first_name": "NICOLE",
        "middle_name": "OLUWABUNMI",
        "name_prefix": "Mrs.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-17",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "000841",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036120392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Lynn, LSW
• Stephen Lyons, L.C.S.W.
• M.H.R.C. Inc.
• Sarah Maas, APN, FNP-BC
• Sierra Maaske, APRN
• Machesney Bay Dialysis, LLC (Forest City Dialysis)
• Melissa Yvonne Macias, MD, PHD
• Amanda Macke, APN
• Sean P Mackenzie, M.D.
• Debra Mackey, RN

• Obstetrics & Gynecology Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.