NPIMap

Individual provider Active NPI

Jeremy Hogg, MD

  • Vascular & Interventional Radiology Physician
  • Urbana, IL
National Provider Identifier
1386834299
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
036129966 Issued in IL
Practice address
611 W Park St
Ir
Urbana, IL 61801-2500
Phone
(217) 904-7000
Fax
(217) 904-7742
NPI assigned
Jul 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 103833 MN
Diagnostic Radiology Physician 2085R0202X 4301090815 MI
Diagnostic Radiology Physician 2085R0202X 036129966 IL
Vascular & Interventional Radiology Physician 2085R0204X 036129966 IL Primary

Addresses

Primary practice location

611 W Park St
Ir
Urbana, IL 61801-2500

Mailing address

611 W. Park St.
BWPC
Urbana, IL 61801-2500
Phone (217) 383-6792

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
I20130815000621 IL Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 9830264530 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Wayne State University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carle West Physician Group IncGroup PAC ID 8921420308, 282 clinicians
Hoopeston Community Memorial HospitalGroup PAC ID 3577456037, shared by 11 NPIs, 142 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians
Richland Memorial Hospital IncGroup PAC ID 3870565732, 107 clinicians

Practice addresses (Care Compare)

2204 Eastland Dr
Bloomington, IL 61704-3567
Phone (309) 663-0222

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

701 E Orange St
Hoopeston, IL 60942-1801
Phone (217) 283-5531

900 E Scott St
Olney, IL 62450-2576
Phone (618) 395-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301090815MIMDDiagnostic Radiology Physician
103833MNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richland Memorial Hospital, Inc CurrentSince Apr 1, 2020 Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Jun 14, 2013 Accepting new patients
Carle West Physician Group Inc CurrentSince Mar 17, 2022 Accepting new patients
Richland Memorial Hospital, Inc Current Accepting new patients
Carle Health Care Incorporated CurrentSince Jul 15, 2013 Accepting new patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Kirby Medical Center CurrentSince Jan 3, 2026 Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Jun 14, 2013 Accepting new patients
Carle Health Care Incorporated Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

3310 Fields South Dr
Champaign, IL 61822
Phone (217) 417-2352

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

1000 Medical Center Dr
Monticello, IL 61856
Phone (217) 762-1540

1304 Franklin Ave
Normal, IL 61761
Phone (309) 268-3590

900 E Scott St
Olney, IL 62450
Phone (618) 345-1000

1201 Ricker Rd
Salem, IL 62881
Phone (618) 548-3194

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 12

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": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1386834299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "BWPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "IR",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-904-7000",
            "fax_number": "217-904-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGG",
        "first_name": "JEREMY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "103833",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301090815",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036129966",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IL",
            "license": "036129966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.