Individual provider Active NPI

Jay Tyler Rohde, MD

  • Pediatrics Physician
  • Washington, IL
National Provider Identifier
1457671745
Registry record updated Aug 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036.135469 Issued in IL
Practice address
10 Saint Clare CT
Washington, IL 61571-9239
Phone
(309) 886-4000
NPI assigned
Jun 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036135469 IL
Pediatrics Physician 208000000X 036.135469 IL Primary

Addresses

Primary practice location

10 Saint Clare CT
Washington, IL 61571-9239

Mailing address

10 Saint Clare CT
Washington, IL 61571-9239
Phone (309) 886-4000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140814001881 IL Practitioner - Internal MedicinePractitioner - Pediatric Medicine 3274750237 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Rush Medical College of Rush University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

10 Saint Clare CT
Washington, IL 61571-9239
Phone (309) 886-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.135469ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Jul 1, 2014 Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Board of Trustees of the University of Illinois Internal Medicine CurrentSince Jul 1, 2014 Accepting new patients

Locations

7694 Solutions Ctr
Chicago, IL 60677

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1 Illini Dr
Peoria, IL 61605
Phone (309) 671-3000

10 Saint Clare Ct
Washington, IL 61571
Phone (309) 886-4000

10 Saint Clare Ct
Ste 100
Washington, IL 61571
Phone (309) 886-4000

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1276041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440892800000",
    "number": "1457671745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SAINT CLARE CT",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615719239",
            "telephone_number": "309-886-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SAINT CLARE CT",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615719239",
            "telephone_number": "309-886-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHDE",
        "first_name": "JAY",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-09",
        "last_updated": "2015-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036135469",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.135469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, IL

Sources for this page

Verify at the official NPI Registry.