Individual provider Active NPI

Jay J Seymour, MD

  • Family Medicine Physician
  • Wheaton, IL
National Provider Identifier
1174545669
Registry record updated Feb 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036094246 Issued in IL
Practice address
7 Blanchard Cir
Suite 200
Wheaton, IL 60187-2039
Phone
(630) 510-9009
Fax
(630) 510-0152
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036094246 IL Primary

Addresses

Primary practice location

7 Blanchard Cir
Suite 200
Wheaton, IL 60187-2039

Mailing address

7 Blanchard Cir
Suite 200
Wheaton, IL 60187-2039
Phone (630) 510-9009

Other identifiers 4

IdentifierTypeStateIssuer
0222075OtherILBLUE CROSS GROUP NUMBER
036094264MedicaidIL
363149833OtherILTAX IDENTIFICATION NUMBER
3631498336019001OtherILCDPG HFS PAYEE ID

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
I20101020000364 IL Practitioner - Family Practice 3476746637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

7 Blanchard Cir
Wheaton, IL 60189-2037
Phone (630) 653-0848

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211
  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Northwestern Medicine Kishwaukee Hospital Hospital, Dekalb, IL, CCN 140286
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
  • Marianjoy Rehabilitation Center Inpatient rehabilitation facility, Wheaton, IL, CCN 143027

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Jul 16, 1999 Accepting new patients
Central Dupage Physician Group Family Medicine CurrentSince Jul 16, 1999 Accepting new patients
Roy J. Betti, M.D.S.C. Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

636 Raymond Dr
Ste 200
Naperville, IL 60563
Phone (630) 355-5302

7 Blanchard Cir
Wheaton, IL 60189
Phone (630) 510-9009

7 Blanchard Cir
Ste 206
Wheaton, IL 60189
Phone (630) 653-0848

7 Blanchard Cir
Ste 200
Wheaton, IL 60189
Phone (630) 510-9009

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

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 7

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1174545669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BLANCHARD CIR",
            "address_2": "SUITE 200",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601872039",
            "telephone_number": "630-510-9009",
            "fax_number": "630-510-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 BLANCHARD CIR",
            "address_2": "SUITE 200",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601872039",
            "telephone_number": "630-510-9009",
            "fax_number": "630-510-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEYMOUR",
        "first_name": "JAY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036094246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP NUMBER",
            "identifier": "0222075",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036094264",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "363149833",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPG HFS PAYEE ID",
            "identifier": "3631498336019001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.