Individual provider Active NPI

Azizur Rahman, MD

  • Ophthalmology Physician
  • Rockford, IL
National Provider Identifier
1346212693
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
O36129423 Issued in IL
Practice address
695 N Perryville Rd
Rockford, IL 61107-6225
Phone
(815) 904-6011
Fax
(815) 904-6171
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X O36129423 IL Primary

Addresses

Primary practice location

695 N Perryville Rd
Rockford, IL 61107-6225

Mailing address

695 N Perryville Rd Ste 3
Rockford, IL 61107-6225
Phone (815) 904-6011

Other identifiers 7

IdentifierTypeStateIssuer
4134410OtherTNTENNCARE SELECT
4134410OtherTNBLUE CROSS BLUE SHIELD
3843144MedicaidTN
4134410OtherTNBLUE CROSS ADVANTAGE
P01320105OtherILRAILROAD MEDICARE
621298175OtherTNDEFAULT
371909283OtherTNTRICARE

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
I20130306000050 IL Practitioner - Ophthalmology 2860461803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

695 N Perryville Rd
Suite 3
Rockford, IL 61107-6225
Phone (815) 904-6011

Hospital & facility affiliations

  • Javon Bea Hospital Hospital, Rockford, IL, CCN 140239

Merit-based Incentive Payment System (MIPS)

Final score
97.5 of 100Reported as individual
Quality
95
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
O36129423ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Rockford Eye Care LLC CurrentSince Mar 24, 2025 Accepting new patients

Locations

695 N Perryville Rd
Ste 3
Rockford, IL 61107
Phone (815) 316-2020

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 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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1346212693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 N PERRYVILLE RD STE 3",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076225",
            "telephone_number": "815-904-6011",
            "fax_number": "815-904-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 N PERRYVILLE RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076225",
            "telephone_number": "815-904-6011",
            "fax_number": "815-904-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHMAN",
        "first_name": "AZIZUR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "O36129423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNCARE SELECT",
            "identifier": "4134410",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4134410",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3843144",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ADVANTAGE",
            "identifier": "4134410",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01320105",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEFAULT",
            "identifier": "621298175",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "371909283",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.