Individual provider Active NPI

Justin Anthony Rapoff, D.O.

  • Internal Medicine Physician
  • Olympia Fields, IL
National Provider Identifier
1174849657
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.143739 Issued in IL
Practice address
20201 Crawford Ave
Olympia Fields, IL 60461-1010
Phone
(708) 747-4000
NPI assigned
Apr 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2014017393 MO
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 036.143739 IL Primary

Addresses

Primary practice location

20201 Crawford Ave
Olympia Fields, IL 60461-1010

Mailing address

6503 Rippling Water Way
Columbia, MO 65201-2888
Phone (618) 541-7110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140710000952 MO Practitioner - Emergency Medicine 6002041399 Reassigns benefits to 2 organizations
I20170920002859 IL Practitioner - Emergency Medicine 6002041399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alton-Griffin Emergency Group PCGroup PAC ID 7315167103, 17 clinicians

Practice addresses (Care Compare)

1 Saint Anthonys Way
Alton, IL 62002-4568
Phone (618) 465-2571

Hospital & facility affiliations

  • Osf Saint Anthony'S Health Center Hospital, Alton, IL, CCN 140052

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95
Improvement activities
40
Cost
80.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014017393MOMDEmergency Medicine Physician
036.143739ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine CurrentSince Aug 30, 2014 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jan 4, 2020 Accepting new patients
Cep America, LLC Emergency Medicine Current Accepting new patients
Alton-Griffin Emergency Group PC Emergency Medicine CurrentSince Jul 31, 2017 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jan 4, 2020 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

100 Medical Plz
Lake St Louis, MO 63367
Phone (636) 625-5200

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

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 1

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": "1270771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1174849657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6503 RIPPLING WATER WAY",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652012888",
            "telephone_number": "618-541-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20201 CRAWFORD AVE",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611010",
            "telephone_number": "708-747-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPOFF",
        "first_name": "JUSTIN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-09",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2014017393",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.143739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

Verify at the official NPI Registry.