Individual provider Active NPI

Isra Mahdi Al Jamed, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Rockford, IL
National Provider Identifier
1477059343
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
336.123053 Issued in IL
Practice address
1401 E State St
Rockford, IL 61104-2298
Phone
(779) 696-4400
NPI assigned
Apr 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 336.123053 IL Primary

Addresses

Primary practice location

1401 E State St
Rockford, IL 61104-2298

Mailing address

1401 E State St
Rockford, IL 61104-2315
Phone (779) 696-4400

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
I20230830002560 IL Practitioner - Emergency Medicine 4587027115 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rockford Emergency Physicians, LLCGroup PAC ID 4385007640, 51 clinicians
Belvidere Emergency Physicians, LLCGroup PAC ID 1254794415, 23 clinicians
Riverside Emergency Physicians LLCGroup PAC ID 6204294119, 35 clinicians

Practice addresses (Care Compare)

1401 E State St
Rockford, IL 61104-2315
Phone (779) 696-4400

1625 S State St
Belvidere, IL 61008-5907
Phone (815) 547-5441

350 N Wall St
Kankakee, IL 60901-2901
Phone (815) 933-1671

Hospital & facility affiliations

  • Uw Health Hospital, Rockford, IL, CCN 140228
  • Riverside Medical Center Hospital, Kankakee, IL, CCN 140186

Merit-based Incentive Payment System (MIPS)

Final score
87.27 of 100Reported as group
Quality
74.46
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
336.123053ILMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Emergency Physicians, LLC CurrentSince Sep 10, 2023 Accepting new patients
Belvidere Emergency Physicians, LLC CurrentSince Sep 10, 2023 Accepting new patients

Locations

1625 S State St
Belvidere, IL 61008
Phone (815) 544-1846

1401 E State St
Rockford, IL 61104
Phone (815) 489-4267

Organizations & group practices 3

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 2

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": "1522540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1477059343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042315",
            "telephone_number": "779-696-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042298",
            "telephone_number": "779-696-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL JAMED",
        "first_name": "ISRA",
        "middle_name": "MAHDI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-01",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IL",
            "license": "336.123053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.