Active NPI
Jerry Yan, M.D
- Cardiovascular Disease Physician
- Rockford, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 036159837
- Practice address
- 1340 Charles St Ste 300
Rockford, IL 61104-2200 - Phone
- (779) 696-4400
- NPI assigned
- May 11, 2016
- Last updated
- Apr 25, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 036159837 | IL | Primary |
Addresses
Primary practice location
1340 Charles St Ste 300
Rockford, IL 61104-2200
Mailing address
1340 Charles St Ste 300
Rockford, IL 61104-2200
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- University of Michigan Medical School, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1340 Charles St
Rockford, IL 61104-2200
1401 E State St
Rockford, IL 61104-2315
Phone (815) 489-4400
1625 S State St
Belvidere, IL 61008-5907
1700 Henry Luckow LN
Belvidere, IL 61008-1702
Phone (779) 696-8650
380 E Il Route 38
Sa Rochelle
Rochelle, IL 61068-9694
Phone (779) 696-9050
6824 Newburg Rd
Sa Valley
Rockford, IL 61108-4330
Phone (779) 696-7610
Hospital & facility affiliations
- Uw Health
- Saint Anthony Medical Center
- Javon Bea Hospital
- University of Wi Hospitals & Clinics Authority
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.51 of 100
- Quality
- 83.2
- Promoting interoperability
- 77
- Improvement activities
- 40
- Cost
- 71.7
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.84 of 100
- Quality
- 75.22
- Promoting interoperability
- 92
- Improvement activities
- 40
- Cost
- 73.11
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swedishamerican Hospital | Current | Accepting new patients | |
| Swedishamerican Hospital | Current | Accepting new patients | |
| Freeport Memorial Hospital | Current | Accepting new patients | |
| Freeport Regional Health Care Foundation | Current | Accepting new patients | |
| Swedishamerican Hospital | Cardiovascular Disease | Current | Accepting new patients |
Locations
1036 W Stephenson St
Freeport, IL 61032
Phone (815) 599-7410
1045 W Stephenson St
Freeport, IL 61032
Phone (815) 599-6105
1340 Charles St
Ste 300
Rockford, IL 61104
Phone (779) 696-5888
2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285
6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610
600 N Rush St
Stockton, IL 61085
Phone (815) 235-3165
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba SwedishAmerican Medical Group
- Family Medicine Physician
- Rockford, IL
- NPI 1962451732
Cardiovascular Disease
-
dba FHN-Memorial Hospital
- General Acute Care Hospital
- Freeport, IL
- NPI 1447228788
-
dba FHN
- Family Medicine Physician
- Freeport, IL
- NPI 1457337016
-
- Community/Retail Pharmacy
- Rockford, IL
- NPI 1306635982
-
- Family Medicine Physician
- Roscoe, IL
- NPI 1386054062
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Rockford, IL
- NPI 1629118609
-
dba OSF Saint Anthony Medical Center
- General Acute Care Hospital
- Rockford, IL
- NPI 1790739977
-
- General Acute Care Hospital
- Rockford, IL
- NPI 1760542732
-
dba University of Wisconsin Hospital and Clinics
- General Acute Care Hospital
- Madison, WI
- NPI 1922043744
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682380800000",
"number": "1336595123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1340 CHARLES ST STE 300",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611042200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1340 CHARLES ST STE 300",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611042200",
"telephone_number": "779-696-4400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAN",
"first_name": "JERRY",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-11",
"last_updated": "2023-04-25",
"certification_date": "2023-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IL",
"license": "036159837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.