Individual provider Active NPI

Jake Musashe, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1477066777
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085006426 Issued in IL
Practice address
1725 W Harrison St Ste 970
Chicago, IL 60612-3828
Phone
(312) 563-3447
NPI assigned
Nov 8, 2017
Last updated
Apr 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085006426 IL Primary

Addresses

Primary practice location

1725 W Harrison St Ste 970
Chicago, IL 60612-3828

Mailing address

1725 W Harrison St Ste 970
Chicago, IL 60612-3828
Phone (312) 563-3447

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171204001179 IL Practitioner - Physician Assistant 6305103193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 563-2875

1725 W Harrison St
Suite 955
Chicago, IL 60612-3862
Phone (312) 942-7030

1725 W Harrison St
Suite 970
Chicago, IL 60612-3828
Phone (312) 563-3447

610 S Maple Ave
Suite 3450
Oak Park, IL 60304-1095
Phone (708) 660-2422

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group CurrentSince Mar 22, 2021 Accepting new patients

Locations

1411 S Michigan Ave
Fl 5
Chicago, IL 60605
Phone (312) 454-2700

1520 W Harrison St
Chicago, IL 60607
Phone (312) 226-2371

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1725 W Harrison St
Ste 1138
Chicago, IL 60612
Phone (312) 563-6000

1725 W Harrison St
Ste 425
Chicago, IL 60612
Phone (312) 563-2558

1725 W Harrison St
Ste 970
Chicago, IL 60612
Phone (312) 563-3447

75 Remittance Dr
Dept 1611
Chicago, IL 60675

610 S Maple Ave
Ste 3450
Oak Park, IL 60304
Phone (312) 563-3447

Interoperability endpoints

  • Direct secure messaging: jmusashe178896@direct.rush.rush-health.com

Organizations & group practices 1

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 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": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1477066777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 970",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123828",
            "telephone_number": "312-563-3447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 970",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123828",
            "telephone_number": "312-563-3447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSASHE",
        "first_name": "JAKE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-08",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.