Individual provider Active NPI

Motaz R Wraikat, DO

  • Hospitalist Physician
  • Carbondale, IL
National Provider Identifier
1073995684
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036146858 Issued in IL
Practice address
405 W Jackson St
Carbondale, IL 62901-1462
Phone
(618) 549-0721
NPI assigned
Jun 19, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036146858 IL
Hospitalist Physician 208M00000X 036146858 IL Primary

Addresses

Primary practice location

405 W Jackson St
Carbondale, IL 62901-1462

Mailing address

1239 E Main St
PO Box 3988
Carbondale, IL 62901-3175
Phone (618) 457-5200

Other practice location 1

201 S 14th St
Herrin, IL 62948-3631
Phone (618) 942-2171

Other practice location 2

2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 684-1035

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address mwraikat25380@sih.direct-ci.com
Direct Messaging Address mwraikat25380@sih.direct-ci.com
Direct Messaging Address mwraikat25380@sih.direct-ci.com

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180808002168 IL Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Undersea and Hyperbaric Medicine 3072861996 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
24 On Physicians PCGroup PAC ID 5698688141, 274 clinicians

Practice addresses (Care Compare)

201 S 14TH St
Herrin, IL 62948-3631
Phone (618) 942-2171

Hospital & facility affiliations

  • Memorial Hospital of Carbondale Hospital, Carbondale, IL, CCN 140164
  • Herrin Hospital Hospital, Herrin, IL, CCN 140011
  • St Joseph Memorial Hospital Hospital, Murphysboro, IL, CCN 141334
  • Harrisburg Medical Center Hospital, Harrisburg, IL, CCN 140210
  • Pinckneyville Community Hospital Hospital, Pinckneyville, IL, CCN 141307

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as group
Quality
77.5
Improvement activities
40
Cost
74.58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036146858ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
24 On Physicians, P.C. Hospitalist CurrentSince Mar 1, 2023 Accepting new patients
24 On Physicians, PC Hospitalist CurrentSince Mar 1, 2023 Accepting new patients
Southern Illinois Medical Services, NFP Internal Medicine CurrentSince Jul 30, 2018 Accepting new patients

Locations

13000 Deerfield Pkwy
Ste 100
Alpharetta, GA 30004

405 W Jackson St
Carbondale, IL 62901

1239 E Main St
Carbondale, IL 62901
Phone 6185490721 ext. 65799

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

201 S 14th St
Herrin, IL 62948
Phone (618) 942-2171

315 S 13th St
Ste 3
Herrin, IL 62948
Phone (618) 988-6157

2 S Hospital Dr
Murphysboro, IL 62966
Phone (618) 684-3156

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

Interoperability endpoints

  • Direct secure messaging: mwraikat25380@sih.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1073995684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 E MAIN ST",
            "address_2": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013175",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W JACKSON ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011462",
            "telephone_number": "618-549-0721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 S 14th St",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483631",
            "country_code": "US",
            "telephone_number": "618-942-2171",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 S Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Murphysboro",
            "state": "IL",
            "postal_code": "629663333",
            "country_code": "US",
            "telephone_number": "618-684-1035",
            "fax_number": "618-684-1036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WRAIKAT",
        "first_name": "MOTAZ",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-19",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036146858",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036146858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwraikat25380@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "201 S 14th St",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwraikat25380@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "405 W Jackson St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwraikat25380@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2 S Hospital Dr",
            "city": "Murphysboro",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629663333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.