Prakash Sidha Jayabalan, M.D., PHD

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

036-140895 Issued in IL

Practice address

355 E Erie St
Chicago, IL 60611-3167

Phone

(312) 238-1000

NPI assigned

Jul 3, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Physical Medicine and RehabilitationAlso: Sports Medicine

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Services RicGroup PAC ID 4880598978, 92 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
• Shirley Ryan Abilitylab Inpatient rehabilitation facility, Chicago, IL, CCN 143026

Merit-based Incentive Payment System (MIPS)

Final score

84.56 of 100Reported as group

Quality

75.1

Promoting interoperability

100

Improvement activities

40

Cost

48.11

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Medical Services Ric

  • Physical Medicine & Rehabilitation Physician
  • Chicago, IL
  • NPI 1659306587
  Medicare reassignment Care Compare group NPD
• Rehabilitation Institute of Chicago

  • Rehabilitation Hospital
  • Chicago, IL
  • NPI 1205879095
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northwestern Memorial Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1497859649
  Care Compare affiliation
• Rehabilitation Institute of Chicago

  • Rehabilitation Hospital
  • Chicago, IL
  • NPI 1205879095

  Inpatient rehabilitation facility

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1457648073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 E ERIE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113167",
            "telephone_number": "312-238-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 E ERIE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113167",
            "telephone_number": "312-238-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYABALAN",
        "first_name": "PRAKASH",
        "middle_name": "SIDHA",
        "name_prefix": "Dr.",
        "credential": "M.D., PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-03",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036140895",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "IL",
            "license": "036-140895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036140895-1",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RIC@direct.ric.org",
            "affiliation": "N",
            "endpointDescription": "Shirley Ryan AbilityLab",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "referrals",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "xml",
            "address_1": "355 E Erie St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606113167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jay Meythaler Psychotherapy PLLC
• Jay R Newmark M D S C
• Jay Sweis D.D.S P.C
• Jay Sweis DDS PC
• Jayne Frances Jay, MHS- CF-SLP
• Jayah Wellness PLLC
• Devi Jayan, PHD
• Aswathi Jayaram, M.D.
• Bangalore N Jayaram, M.D.
• Avinash Jayaraman, MD, MBA

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.