Jacob Stephen, M.D

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

036133593 Issued in IL

Practice address

1850 Gateway Dr
Sycamore, IL 60178-3192

Phone

(630) 232-0280

Fax

(630) 232-3895

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Interventional Cardiology

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

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

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine Kishwaukee Hospital Hospital, Dekalb, IL, CCN 140286
• Valley West Community Hospital Hospital, Sandwich, IL, CCN 141340
• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
• Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233
• Rochelle Community Hospital Hospital, Rochelle, IL, CCN 141312

Merit-based Incentive Payment System (MIPS)

Final score

95.19 of 100Reported as apm

Quality

83.05

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

95.63 of 100Reported as apm

Quality

88.47

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

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

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
• Kishwaukee Community Hospital

  • General Acute Care Hospital
  • Dekalb, IL
  • NPI 1669534517
  Care Compare affiliation
• Rochelle Community Hospital Association

  • Critical Access Hospital
  • Rochelle, IL
  • NPI 1821053216
  Care Compare affiliation
• Saint Anthony Medical Center

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1790739977
  Care Compare affiliation
• Valley West Community Hospital

  • Critical Access Hospital
  • Sandwich, IL
  • NPI 1184705931
  Care Compare affiliation

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1174624415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 KISH HOSPITAL DR STE 103",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159602",
            "telephone_number": "630-232-0280",
            "fax_number": "630-232-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 GATEWAY DR",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783192",
            "telephone_number": "630-232-0280",
            "fax_number": "630-232-3895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Kish Hospital Dr Ste 103",
            "address_purpose": "LOCATION",
            "city": "Dekalb",
            "state": "IL",
            "postal_code": "601159602",
            "country_code": "US",
            "telephone_number": "630-232-0280",
            "fax_number": "630-232-3895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHEN",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35.083380",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036133593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "206147",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVID PTAN",
            "identifier": "F40332641",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcus Stammen, DO
• Ashli Stanfa, FNP-BC
• Matthew Stark, MS, RDN, LDN
• Bridget Starks, LMT
• Roger Stedman, PHARMD
• Bonnie Stewart-Henson, SLP
• Kathryn Stiltner, PHARMD
• Taylor Stinnett, DO
• Elzbieta Stolarski, P.T.
• Paul Martin Stromborg, MD

• Interventional Cardiology Physician in Sycamore, IL
• Providers in Sycamore, IL by specialty
• Interventional Cardiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.