Individual provider Active NPI

Jagdish Muzumdar, M.D., FACEP

  • Emergency Medicine Physician
  • Oak Park, IL
National Provider Identifier
1467477703
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Practice address
3 Erie CT
Oak Park, IL 60302-2519
Phone
(708) 383-6200
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X IN
Emergency Medicine Physician 207P00000X IL Primary

Addresses

Primary practice location

3 Erie CT
Oak Park, IL 60302-2519

Mailing address

1303 Midwest Club Pkwy
Oak Brook, IL 60523-2519
Phone (630) 920-9372

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
I20041228000073 IL Practitioner - Emergency Medicine 7012975832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage Emergency Physicians Convenient Care LLCGroup PAC ID 6608840046, 30 clinicians

Practice addresses (Care Compare)

6840 Main St
Downers Grove, IL 60516-3425
Phone (630) 275-6840

Hospital & facility affiliations

  • Advocate Good Samaritan Hospital Hospital, Downers Grove, IL, CCN 140288

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-055322ILMDEmergency Medicine Physician
010293151AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Emergency Physicians Convenient Care LLC Emergency Medicine CurrentSince Aug 10, 2022 Accepting new patients
Fischer Mangold/Joliet Emergency Medicine Past Accepting new patients
Dupage Emergency Physicians LTD Emergency Medicine Past Accepting new patients
Berwyn Emergency Physicians, LLP Emergency Medicine Past Accepting new patients
Illiana Emergency Physicians LLP Emergency Medicine Past Accepting new patients
West Side Emergency Physicians, LLP Emergency Medicine Past Accepting new patients

Locations

6840 Main St
Downers Grove, IL 60516
Phone (630) 275-6840

15900 W 127th St
Lemont, IL 60439
Phone (630) 243-7100

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 and National Provider Directory roles.

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467477703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 MIDWEST CLUB PKWY",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232519",
            "telephone_number": "630-920-9372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ERIE CT",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022519",
            "telephone_number": "708-383-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUZUMDAR",
        "first_name": "JAGDISH",
        "credential": "M.D., FACEP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.