Individual provider Active NPI

Rayan Jo Rachwan, MD

  • Cardiovascular Disease Physician
  • Madison, WI
National Provider Identifier
1477073856
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036167086 Issued in IL
Practice address
600 Highland Ave
Madison, WI 53792-3082
Phone
(608) 287-2434
NPI assigned
Jun 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11019641A IN
Internal Medicine Physician 207R00000X 036167086 IL
Cardiovascular Disease Physician 207RC0000X 72695 WI
Interventional Cardiology Physician 207RI0011X 036167086 IL
Cardiovascular Disease Physician 207RC0000X 036167086 IL Primary

Addresses

Primary practice location

600 Highland Ave
Madison, WI 53792-3082

Mailing address

Uw Hospitals & Clinics 600 Highland Ave
Madison, WI 53792-0001

Other practice location 1

340 W 10th St
Indianapolis, IN 46202-3082
Phone (317) 274-3772

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
I20240507002705 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8123397189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

1401 E 12TH St
Mendota, IL 61342-9216
Phone (815) 227-5600

444 Roxbury Rd
Rockford, IL 61107-5059
Phone (815) 398-3000

5666 E State St
Rockford, IL 61108-2425
Phone (815) 921-8929

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

  • Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233
  • Osf Saint Paul Medical Center Hospital, Mendota, IL, CCN 141310
  • Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
  • Osf Saint Clare Medical Center Hospital, Princeton, IL, CCN 141337
  • Osf Saint Katharine Medical Center Hospital, Dixon, IL, CCN 140012

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting15
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72695WIMDCardiovascular Disease Physician
036167086ILMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Apr 24, 2024 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Major Hospital Past Accepting new patients

Locations

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

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

444 Roxbury Rd
Rockford, IL 61107
Phone (815) 395-9196

444 Roxbury Rd
#12471
Rockford, IL 61107

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 5

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": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1477073856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UW HOSPITALS & CLINICS 600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537923082",
            "telephone_number": "608-287-2434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "340 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462023082",
            "country_code": "US",
            "telephone_number": "317-274-3772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RACHWAN",
        "first_name": "RAYAN JO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-26",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "11019641A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036167086",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "72695",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036167086",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036167086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.