NPIMap

Individual provider Active NPI

Jeffrey D Arendell, DO

  • Emergency Medicine Physician
  • Granite City, IL
National Provider Identifier
1386668218
Registry record updated Jan 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036086735 Issued in IL
Practice address
2100 Madison Ave
Granite City, IL 62040-4701
Phone
(618) 798-6300
Fax
(618) 798-3716
NPI assigned
Jul 26, 2006
Last updated
Jan 21, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036086735 IL Primary

Addresses

Primary practice location

2100 Madison Ave
Granite City, IL 62040-4701

Mailing address

6713 Stoneridge Est
Columbia, IL 62236-2905
Phone (618) 476-1967

Other identifiers 2

IdentifierTypeStateIssuer
036086735-3MedicaidIL
3932056OtherILBLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040311000187 IL Practitioner - Emergency Medicine 4082503867 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1991
Medicare assignment
May accept Medicare assignment
Group practices
Ahs Il Medical Group LLCGroup PAC ID 5496111676, 46 clinicians

Practice addresses (Care Compare)

2100 Madison Ave
Granite City, IL 62040-4713
Phone (618) 798-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
77.51 of 100Reported as group
Quality
49.04
Promoting interoperability
95
Improvement activities
40
Cost
69.42

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Illinois Specialty Clinic, Inc. CurrentSince May 1, 2023 Accepting new patients
Ahs Il Medical Group LLC CurrentSince Mar 1, 2023 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. CurrentSince May 1, 2023 Accepting new patients
Integritas Emergency Physician Services, LLC Emergency Medicine CurrentSince May 30, 2018 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. Current Accepting new patients

Locations

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

2250 N Illinois Ave
Carbondale, IL 62901
Phone (618) 833-1691

1000 Eleven S
Ste 1A
Columbia, IL 62236
Phone (618) 281-8400

4273 S State Route 159
Glen Carbon, IL 62034
Phone (618) 288-2297

2044 Madison Ave
Ste 27
Granite City, IL 62040
Phone (618) 451-0700

2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000

2100 Madison Ave
Ste 301
Granite City, IL 62040

303 S Commercial St
Harrisburg, IL 62946
Phone (618) 767-6050

8 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 244-5500

325 Spring St
Redbud, IL 62278
Phone (618) 282-5165

619 Edwardsville Rd
Troy, IL 62294
Phone (618) 667-1200

Interoperability endpoints

  • Direct secure messaging: jarendel@yourcarecommunity.org

Organizations & group practices 6

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.

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232496000000",
    "number": "1386668218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6713 STONERIDGE EST",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622362905",
            "telephone_number": "618-476-1967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MADISON AVE",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404701",
            "telephone_number": "618-798-6300",
            "fax_number": "618-798-3716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARENDELL",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2009-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036086735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036086735-3",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "3932056",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Granite City, IL

Sources for this page

Verify at the official NPI Registry.