Individual provider Active NPI

Muamer Mulasmajic, APN

  • Nephrology Physician
  • Rockford, IL
National Provider Identifier
1326526716
Registry record updated Jul 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
209017897 Issued in IL
Practice address
612 Roxbury Rd
Rockford, IL 61107-5089
Phone
(815) 227-8300
NPI assigned
Jul 30, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 209017897 IL Primary

Addresses

Primary practice location

612 Roxbury Rd
Rockford, IL 61107-5089

Mailing address

612 Roxbury Rd
Rockford, IL 61107-5089
Phone (815) 227-8300

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180823000915 IL Practitioner - Nurse Practitioner 5890044903 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiorenal Therapeutics of Illinois PLLCGroup PAC ID 5395159677, 32 clinicians

Practice addresses (Care Compare)

18 W140 Butterfield Rd
Suite 1558
Oakbrook Terrace, IL 60181-4843
Phone (904) 490-0264

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rna of Rockford, PLLC Nephrology CurrentSince Aug 1, 2018 Accepting new patients
Cardiorenal Therapeutics of Illinois PLLC Nephrology CurrentSince Sep 1, 2021 Accepting new patients
Rockford Health Physicians CurrentSince Jan 6, 2020 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

612 Roxbury Rd
Rockford, IL 61107
Phone (815) 227-8300

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

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 3

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": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1326526716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075089",
            "telephone_number": "815-227-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075089",
            "telephone_number": "815-227-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULASMAJIC",
        "first_name": "MUAMER",
        "name_prefix": "Mr.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "209017897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.