Active NPI
Jay Foster Wigboldy, MD
- Diagnostic Radiology Physician
- Indianapolis, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 01079663A
- Practice address
- 5901 Technology Center Dr
Indianapolis, IN 46278-6013 - Phone
- (317) 972-9669
- Fax
- (317) 715-9990
- NPI assigned
- Nov 15, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 01079663A | IN | Primary |
| Diagnostic Radiology Physician | 2085R0202X | 34489 | KY | |
| Diagnostic Radiology Physician | 2085R0202X | 036144663 | IL |
Addresses
Primary practice location
5901 Technology Center Dr
Indianapolis, IN 46278-6013
Mailing address
5901 Technology Center Dr
Indianapolis, IN 46278-6013
Phone (317) 972-9669
Other practice location 1
801 S Milwaukee Ave
Libertyville, IL 60048-3204
Phone (847) 362-2900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300055776 | Medicaid | IN |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
| Direct Messaging Address | jwigboldy445485@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Indiana University School of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1775 Dempster St
Park Ridge, IL 60068-1143
214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160
801 S Milwaukee Ave
Libertyville, IL 60048-3204
Phone (847) 279-0061
801 S Milwaukee Ave BLDG
Suite 880
Libertryville, IL 60048-3204
Phone (847) 990-5910
Hospital & facility affiliations
- Advocate Condell Medical Center
- Advocate Lutheran General Hospital
- Northshore University Healthsystem - Evanston Hospital
- Advocate Illinois Masonic Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 68 of 100
- Quality
- 80
- Improvement activities
- 0
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036144663 | IL | MD | Diagnostic Radiology Physician |
| 01079663A | IN | MD | Diagnostic Radiology Physician |
| 34489 | KY | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health & Hospitals Corporation | Current | Accepting new patients | |
| Northwest Radiology Network P C | Diagnostic Radiology | Current | Accepting new patients |
| Central Illinois Radiological Associates, LTD. | Diagnostic Radiology | Current | Accepting new patients |
| Roswell Clinic Corp | Past | Accepting new patients | |
| Cira Michigan PC | Diagnostic Radiology | Past | Accepting new patients |
| Tri-State Radiology, P.C. | Diagnostic Radiology | Past | Accepting new patients |
Locations
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
29373 Network Pl
Chicago, IL 60673
5200 Reliable Pkwy
Chicago, IL 60686
Phone (309) 671-8748
5900 Bond Ave
East Saint Louis, IL 62207
Phone (618) 332-3060
801 S Milwaukee Ave
Libertyville, IL 60048
Phone (847) 362-2900
530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553
111 Oakwood Rd
Peoria, IL 61611
Phone (586) 412-4144
10603 N Meridian St
Carmel, IN 46290
Phone (317) 415-6050
5901 Technology Center Dr
Indianapolis, IN 46278
Phone (317) 328-4777
Interoperability endpoints
- jwigboldy445485@direct.myadvocateaurora.org
Organizations & group practices 8
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.
-
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
- Diagnostic Radiology Physician
- Indianapolis, IN
- NPI 1447259338
-
- Diagnostic Radiology Physician
- Peoria, IL
- NPI 1538192828
IN
-
- Medical Specialty Clinic/Center
- Oak Lawn, IL
- NPI 1912936014
-
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
-
- Diagnostic Radiology Physician
- Escanaba, MI
- NPI 1972141513
-
- Family Medicine Physician
- Roswell, NM
- NPI 1649267618
-
- Diagnostic Ultrasound Physician
- Port Jervis, NY
- NPI 1164474532
Diagnostic Radiology
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Libertyville, IL
- NPI 1124272547
-
- Mobile Mammography Clinic/Center
- Grayslake, IL
- NPI 1770737199
Hospital
-
- General Acute Care Hospital
- Park Ridge, IL
- NPI 1164539730
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1912014564
-
- General Acute Care Hospital
- Evanston, IL
- NPI 1184670549
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769040000000",
"number": "1487636569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5901 TECHNOLOGY CENTER DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462786013",
"telephone_number": "317-972-9669",
"fax_number": "317-715-9990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5901 TECHNOLOGY CENTER DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462786013",
"telephone_number": "317-972-9669",
"fax_number": "317-715-9990"
}
],
"practiceLocations": [
{
"address_1": "801 S Milwaukee Ave",
"address_purpose": "LOCATION",
"city": "Libertyville",
"state": "IL",
"postal_code": "600483204",
"country_code": "US",
"telephone_number": "847-362-2900",
"fax_number": "847-990-5292",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WIGBOLDY",
"first_name": "JAY",
"middle_name": "FOSTER",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-15",
"last_updated": "2026-01-22",
"certification_date": "2026-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IN",
"license": "01079663A",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "KY",
"license": "34489",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "036144663",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300055776",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "Ability Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "64 S Price Rd Ste B",
"city": "Brownsville",
"state": "TX",
"country_code": "US",
"postal_code": "785212459",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jwigboldy445485@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "801 S Milwaukee Ave",
"city": "Libertyville",
"state": "IL",
"country_code": "US",
"postal_code": "600483204",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "801 S Milwaukee Ave",
"city": "Libertyville",
"state": "IL",
"country_code": "US",
"postal_code": "600483204",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.