Individual provider Active NPI

Jyothi Gogineni, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Huntley, IL
National Provider Identifier
1265624282
Registry record updated Oct 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036-122492 Issued in IL
Practice address
10370 Haligus Rd Ste 117
Huntley, IL 60142
Phone
(815) 338-6600
Fax
(847) 702-7207
NPI assigned
Aug 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036-122492 IL Primary

Addresses

Primary practice location

10370 Haligus Rd Ste 117
Huntley, IL 60142

Mailing address

10370 Haligus Rd Ste 117
Huntley, IL 60142-9582
Phone (815) 338-6600

Other practice location 1

360 Station Dr Fl 3
Crystal Lake, IL 60014-7978
Phone (815) 338-6600

Other identifiers 1

IdentifierTypeStateIssuer
036122492OtherILSTATE LICENSE

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
I20090708000266 IL Practitioner - Endocrinology 8729139597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2001
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)

10370 Haligus Rd
Huntley, IL 60142-9582

10400 Haligus Rd
Huntley, IL 60142-9553
Phone (815) 356-2323

10450 Algonquin Rd
Huntley, IL 60142-7064
Phone (815) 444-2900

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

360 Station Dr
Suite 300
Crystal Lake, IL 60014-8003
Phone (847) 802-7070

4201 W Medical Ctr Dr
McHenry, IL 60050-8409
Phone (815) 759-4874

4309 W Medical Ctr Dr
Suite A200
McHenry, IL 60050-8437
Phone (815) 759-8070

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291
  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281

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

State licenses

LicenseStateTypeSpecialty
036-122492ILMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince May 1, 2019 Accepting new patients
Central Dupage Physician Group Endocrinology, Diabetes & Metabolism CurrentSince May 1, 2019 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

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

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

360 Station Dr
Fl 3
Crystal Lake, IL 60014
Phone (815) 759-8070

360 Station Dr
Ste 300
Crystal Lake, IL 60014
Phone (815) 455-1800

11650 S State Route 47
Huntley, IL 60142
Phone (847) 802-7300

10370 Haligus Rd
Ste 117
Huntley, IL 60142
Phone (815) 344-3900

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

Organizations & group practices 2

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 6

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": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1265624282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10370 HALIGUS RD STE 117",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601429582",
            "telephone_number": "815-338-6600",
            "fax_number": "847-702-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10370 HALIGUS RD STE 117",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "60142",
            "telephone_number": "815-338-6600",
            "fax_number": "847-702-7207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360 Station Dr Fl 3",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600147978",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "fax_number": "815-356-2388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOGINENI",
        "first_name": "JYOTHI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036-122492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036122492",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntley, IL

Sources for this page

Verify at the official NPI Registry.