Active NPI
Jaziel Chavira
- Nurse Practitioner
- Sterling, IL
National Provider Identifier
1114535903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209021433
- Practice address
- 101 E Miller Rd
Sterling, IL 61081-1252 - Phone
- (815) 625-4790
- NPI assigned
- Jul 17, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209021433 | IL | Primary |
Addresses
Primary practice location
101 E Miller Rd
Sterling, IL 61081-1252
Mailing address
101 E Miller Rd
Sterling, IL 61081-1252
Phone (815) 625-4790
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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200929000796 | IL | Practitioner - Nurse Practitioner | 8426477241 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
101 E Miller Rd
Sterling, IL 61081-1252
Phone (815) 625-4790
Hospital & facility affiliations
- CGH Medical Center
- Osf Saint Katharine Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.05 of 100
- Quality
- 72.1
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209021433 | IL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CGH Medical Center | Current | Accepting new patients | |
| CGH Medical Center | Current | Accepting new patients | |
| CGH Medical Center | Past | Accepting new patients |
Locations
101 E Miller Rd
Sterling, IL 61081
Phone (815) 632-5285
Interoperability endpoints
- jchavira20116@cghmc.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.
-
- Durable Medical Equipment & Medical Supplies
- Morrison, IL
- NPI 1447415724
-
- Family Medicine Physician
- Sterling, IL
- NPI 1548540636
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": "1594944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594944000000",
"number": "1114535903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 E MILLER RD",
"city": "STERLING",
"state": "IL",
"postal_code": "610811252",
"telephone_number": "815-625-4790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 E MILLER RD",
"city": "STERLING",
"state": "IL",
"postal_code": "610811252",
"telephone_number": "815-625-4790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVIRA",
"first_name": "JAZIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-17",
"last_updated": "2020-07-17",
"certification_date": "2020-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209021433",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sterling, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; 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.