Mohammad Ali Kizilbash, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

036-111516 Issued in IL

Practice address

4309 W Medical Center Dr Ste A200
McHenry, IL 60050

Phone

(815) 759-8070

Fax

(815) 759-4931

NPI assigned

Dec 8, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
• Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
• Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
• Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211

Merit-based Incentive Payment System (MIPS)

Final score

95.19 of 100Reported as apm

Quality

83.05

Promoting interoperability

100

Improvement activities

40

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.

• Northwestern Medical Faculty Foundation

  • Multi-Specialty Clinic/Center
  • Carol Stream, IL
  • NPI 1346235314
  Medicare reassignment Care Compare group NPD
• Central Dupage Physician Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844
  Medicare reassignment NPD
• Central Dupage Physician Group

  • Orthopaedic Surgery Physician
  • Geneva, IL
  • NPI 1780012344
  NPD
• Northwestern Medical Faculty Foundation

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1417718479
  NPD
• Heartcare Midwest , LTD

  • Cardiovascular Disease Physician
  • Peoria, IL
  • NPI 1720023179
  NPD (past)

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

• Central Dupage Hospital Association

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation
• Delnor Community Hospital

  • General Acute Care Hospital
  • Geneva, IL
  • NPI 1407859655
  Care Compare affiliation
• Northern Illinois Medical Center

  • General Acute Care Hospital
  • McHenry, IL
  • NPI 1982611281
  Care Compare affiliation
• Northwestern Lake Forest Hospital

  • General Acute Care Hospital
  • Lake Forest, IL
  • NPI 1124025176
  Care Compare affiliation
• Northwestern Memorial Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1497859649
  Care Compare affiliation

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

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1114162948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 W MEDICAL CENTER DR STE A200",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508437",
            "telephone_number": "815-759-8070",
            "fax_number": "815-759-4931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 W MEDICAL CENTER DR STE A200",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "60050",
            "telephone_number": "815-759-8070",
            "fax_number": "815-759-4931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1340 Charles St",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611042200",
            "country_code": "US",
            "telephone_number": "815-490-5888",
            "fax_number": "815-490-5898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "360 Station Dr Fl 3",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600147978",
            "country_code": "US",
            "telephone_number": "815-759-8070",
            "fax_number": "815-759-4931",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10370 Haligus Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601429582",
            "country_code": "US",
            "telephone_number": "815-759-8070",
            "fax_number": "815-759-4931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIZILBASH",
        "first_name": "MOHAMMAD",
        "middle_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-08",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2009030104",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036-111516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036111516",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Hyunil Kim, M.D.
• Steven S Kim, M.D.
• Aaron T Kinert
• Kathryn Elaine King
• Lowell Kivley
• Samuel Burk Klasky
• Catherine Kleczynski, OTR/L
• Kelly Lisa Klein, RN
• Caitlin Kleist
• Raquel Reyes Klinger

• Cardiovascular Disease Physician in McHenry, IL
• Providers in McHenry, IL by specialty
• Cardiovascular Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2018; 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.