Alexander David Raw, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

036-144397 Issued in IL

Practice address

1600 W Walnut St BLDG 3
Jacksonville, IL 62650-1136

Phone

(217) 243-8455

Fax

(217) 243-7951

NPI assigned

Jun 27, 2013

Last updated

Dec 9, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

University of Pittsburgh School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jacksonville Memorial Hospital Hospital, Jacksonville, IL, CCN 141352

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alexanderraw@siusm.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Siu Physicians & Surgeons, Inc

  dba SIU HealthCare

  • Endocrinology, Diabetes & Metabolism Physician
  • Springfield, IL
  • NPI 1558385989
  Medicare reassignment Care Compare group NPD
• Board of Trustees of Southern Illinois University

  dba Carbondale Care A Van

  • Rural Health Clinic/Center
  • Carbondale, IL
  • NPI 1215978127
  NPD
• Siu Physicians & Surgeons, Inc

  • Durable Medical Equipment & Medical Supplies
  • Springfield, IL
  • NPI 1164055976
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Passavant Memorial Area Hospital Association

  dba Passavant Area Hospital

  • Critical Access Hospital
  • Jacksonville, IL
  • NPI 1174580831
  Care Compare affiliation

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1316387947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501136",
            "telephone_number": "217-243-8455",
            "fax_number": "217-243-7951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W WALNUT ST BLDG 3",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501136",
            "telephone_number": "217-243-8455",
            "fax_number": "217-243-7951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 N 9th St Ste 6W100",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627025303",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-7958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAW",
        "first_name": "ALEXANDER",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-27",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-144397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036-144397",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alexanderraw@siusm.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "415 N 9th St Ste 6W100",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627025303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alexanderraw@siusm.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1600 W Walnut St Bldg 3",
            "city": "Jacksonville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "626501136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rebecca Beth Pritikin, M.ED, LAT, ATC
• R & D Pharmacies, Inc
• Constance Racine Radford, MSOT
• Tara Jean Ramsey, M.D.
• Bethany Danielle Randall, COTA
• Lynne N Redick
• Reese Family Chiropractic Service Corporation
• Douglas K Reese, DC
• Regional Orthopaedics & Sports Medicine Center, LTD.
• Shelley L Reither, LCPC

• Obstetrics & Gynecology Physician in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.

Verify at the official NPI Registry.