Individual provider Active NPI

Jessica Bode, M.D.

  • Emergency Medicine Physician
  • Joliet, IL
National Provider Identifier
1417343575
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036145780 Issued in IL
Practice address
333 Madison St
Joliet, IL 60435-8200
Phone
(815) 725-7133
NPI assigned
Apr 15, 2015
Last updated
Mar 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01083253A IN
Emergency Medicine Physician 207P00000X 1417343575 IL
Emergency Medicine Physician 207P00000X 036.145780 IL
Emergency Medicine Physician 207P00000X A170445 CA
Emergency Medicine Physician 207P00000X 036145780 IL Primary

Addresses

Primary practice location

333 Madison St
Joliet, IL 60435-8200

Mailing address

333 Madison St
Joliet, IL 60435-8200
Phone (815) 725-7133

Other practice location 1

1000 N Westmoreland Rd
Lake Forest, IL 60045-1658
Phone (847) 234-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20201208001470 CA Practitioner - Emergency Medicine 6103121066 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Tennessee, HSC, College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, shared by 2 NPIs, 1,278 clinicians

Practice addresses (Care Compare)

180 Rowland Way
Novato, CA 94945-5009
Phone (415) 209-1300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A170445CAMDEmergency Medicine Physician
036.145780ILMDEmergency Medicine Physician
1417343575ILMDEmergency Medicine Physician
01083253AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America - California Emergency Medicine CurrentSince Nov 20, 2023 Accepting new patients
Regents Univ of California UCSF CurrentSince Feb 25, 2021 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Nov 27, 2020 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America-California Emergency Medicine CurrentSince Nov 27, 2020 Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

1650 Creekside Dr
Folsom, CA 95630
Phone (916) 983-7400

250 Bon Air Rd
Kentfield, CA 94904
Phone (415) 464-1350

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

180 Rowland Way
Novato, CA 94945
Phone (415) 209-1300

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

4000 Civic Center Dr
Ste 206
San Rafael, CA 94903
Phone (415) 492-4800

Interoperability endpoints

  • Direct secure messaging: jbode562910@hisp.ehr.sutterhealth.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 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": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1417343575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 MADISON ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358200",
            "telephone_number": "815-725-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 MADISON ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358200",
            "telephone_number": "815-725-7133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 N Westmoreland Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Forest",
            "state": "IL",
            "postal_code": "600451658",
            "country_code": "US",
            "telephone_number": "847-234-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODE",
        "first_name": "JESSICA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01083253A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "1417343575",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.145780",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A170445",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036145780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.