Individual provider Active NPI

William Stephen Minore, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Rockford, IL
National Provider Identifier
1104859107
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
036.075603 Issued in IL
Practice address
1235 N Mulford Rd Ste 222
Rockford, IL 61107-3879
Phone
(815) 397-8400
Fax
(815) 229-0050
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036-075603 IL
Pain Medicine (Anesthesiology) Physician 207LP2900X 036.075603 IL Primary

Addresses

Primary practice location

1235 N Mulford Rd Ste 222
Rockford, IL 61107-3879

Mailing address

2202 Harlem Rd
Loves Park, IL 61111-2754
Phone (815) 877-4848

Other identifiers 2

IdentifierTypeStateIssuer
036075603MedicaidIL
027274OtherHEALTH ALLIANCE

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
I20050421001234 IL Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 0941105779 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Michigan Medical School, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Pain Management Services, LTD.Group PAC ID 4284693755, 6 clinicians
Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

1235 N Mulford Rd
Suite 222
Rockford, IL 61107-3879
Phone (815) 397-8400

1401 E State St
Rockford, IL 61104-2315
Phone (815) 968-4400

1625 S State St
Belvidere, IL 61008-5907
Phone (815) 544-1846

6824 Newburg Rd
Sa Valley
Rockford, IL 61108-4330
Phone (779) 696-7610

Hospital & facility affiliations

  • Uw Health Hospital, Rockford, IL, CCN 140228
  • Osf Saint Katharine Medical Center Hospital, Dixon, IL, CCN 140012

Merit-based Incentive Payment System (MIPS)

Final score
81.51 of 100Reported as group
Quality
83.2
Promoting interoperability
77
Improvement activities
40
Cost
71.7

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-075603ILMDAnesthesiology Physician
036.075603ILMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Anesthesiologists Associated, L.L.C. Anesthesiology CurrentSince Jan 1, 1987 Accepting new patients
Swedishamerican Hospital CurrentSince Dec 12, 2022 Accepting new patients
Swedishamerican Hospital CurrentSince Dec 12, 2022 Accepting new patients
Medical Pain Management Services, LTD. CurrentSince Jan 1, 1994 Accepting new patients
Rockford Hyperbaric Healing Center, Inc Past Accepting new patients

Locations

2202 Harlem Rd
#200
Loves Park, IL 61111
Phone (815) 877-4848

2202 Harlem Rd
Loves Park, IL 61111
Phone (815) 877-4848

1235 N Mulford Rd
Rockford, IL 61107
Phone (815) 397-0077

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

1235 N Mulford Rd
Ste 222
Rockford, IL 61107
Phone (815) 397-8400

1401 E State St
Rockford, IL 61104
Phone (815) 489-4267

Organizations & group practices 5

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 2

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1104859107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 HARLEM RD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611112754",
            "telephone_number": "815-877-4848",
            "fax_number": "815-654-5342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 N MULFORD RD STE 222",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073879",
            "telephone_number": "815-397-8400",
            "fax_number": "815-229-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINORE",
        "first_name": "WILLIAM",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036-075603",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036.075603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036075603",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "027274",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.