Individual provider Active NPI

Marek S Bentkowski, MD

  • Family Medicine Physician
  • Roscoe, IL
National Provider Identifier
1437167277
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-105459 Issued in IL
Practice address
5605 E. Rockton Road
Northpointe Clinic
Roscoe, IL 61073-7601
Phone
(815) 525-4500
Fax
(815) 525-4505
NPI assigned
Aug 4, 2006
Last updated
Oct 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-105459 IL Primary
Family Medicine Physician 207Q00000X 44662-020 WI

Addresses

Primary practice location

5605 E. Rockton Road
Northpointe Clinic
Roscoe, IL 61073-7601

Mailing address

1905 E. Huebbe Parkway
Beloit Health System Inc
Beloit, WI 53511-1842
Phone (608) 364-2200

Other identifiers 2

IdentifierTypeStateIssuer
1437167277MedicaidWI
036105459MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100120000507 WI Practitioner - Family Practice 7113069725 Reassigns benefits to 1 organization
I20100824001269 IL Practitioner - Family Practice 7113069725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beloit Health System IncGroup PAC ID 8224947858, shared by 4 NPIs, 138 clinicians

Practice addresses (Care Compare)

1735 Madison Rd
Beloit, WI 53511-3216
Phone (608) 363-7510

1905 E Huebbe Pkwy
Beloit, WI 53511-1842
Phone (608) 363-5000

5601 E Rockton Rd
Roscoe, IL 61073-7601
Phone (815) 525-4800

5605 E Rockton Rd
Roscoe, IL 61073-7641
Phone (608) 364-5011

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.93 of 100Reported as group
Quality
64.82
Promoting interoperability
100
Improvement activities
40
Cost
71.63

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-105459ILMDFamily Medicine Physician
44662-020WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beloit Clinic, S.C. Family Medicine Current Accepting new patients
Beloit Health System, Inc CurrentSince Jan 1, 2010 Accepting new patients
Beloit Health System Inc Family Medicine Current Accepting new patients
Beloit Health System Inc Family Medicine CurrentSince Jan 1, 2010 Accepting new patients
Beloit Health System, Inc CurrentSince Jan 1, 2010 Accepting new patients
Beloit Health System, Inc Family Medicine Past Accepting new patients

Locations

5605 E Rockton Rd
Roscoe, IL 61073
Phone (815) 525-4000

1701 Blackhawk Blvd
South Beloit, IL 61080
Phone (815) 389-2268

1735 Madison Rd
Beloit, WI 53511
Phone (608) 363-7510

1905 E Huebbe Pkwy
Beloit, WI 53511
Phone (608) 364-2293

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

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 4

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1437167277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 E. HUEBBE PARKWAY",
            "address_2": "BELOIT HEALTH SYSTEM INC",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-2200",
            "fax_number": "608-363-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5605 E. ROCKTON ROAD",
            "address_2": "NORTHPOINTE CLINIC",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610737601",
            "telephone_number": "815-525-4500",
            "fax_number": "815-525-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTKOWSKI",
        "first_name": "MAREK",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-105459",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "44662-020",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437167277",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105459",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roscoe, IL

Sources for this page

Verify at the official NPI Registry.