Fadi M Mustapha, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

036-115681 Issued in IL

Practice address

215 E 1St St
Dixon, IL 61021

Phone

(815) 285-5843

Fax

(815) 285-5846

NPI assigned

Jun 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Gastroenterology

Education

Other, 1999

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)

Hospital & facility affiliations

• Osf Saint Katharine Medical Center Hospital, Dixon, IL, CCN 140012
• Osf Saint Clare Medical Center Hospital, Princeton, IL, CCN 141337

Merit-based Incentive Payment System (MIPS)

Final score

82.78 of 100Reported as group

Quality

60.49

Promoting interoperability

100

Improvement activities

40

Cost

77.11

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Katherine Shaw Bethea Hospital

  • General Acute Care Hospital
  • Dixon, IL
  • NPI 1427043546
  Medicare reassignment NPD
• KSB Medical Group, Inc.

  • Family Medicine Physician
  • Dixon, IL
  • NPI 1073592119

  Gastroenterology

  Medicare reassignment NPD
• KSB Medical Group, Inc.

  • Eyewear Supplier
  • Dixon, IL
  • NPI 1306814603
  NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Cardinal Medical Group, LTD.

  • Multi-Specialty Clinic/Center
  • Peoria, IL
  • NPI 1992829485
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Osf Healthcare System

  • Critical Access Hospital
  • Princeton, IL
  • NPI 1093308439
  Care Compare affiliation
• Osf Healthcare System

  • General Acute Care Hospital
  • Dixon, IL
  • NPI 1508683590
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1508801986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E 1ST ST",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213175",
            "telephone_number": "815-285-5843",
            "fax_number": "815-285-5846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E 1ST ST",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "61021",
            "telephone_number": "815-285-5843",
            "fax_number": "815-285-5846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTAPHA",
        "first_name": "FADI",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036-115681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K28334",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS MEDICAL LICENSE",
            "identifier": "036-115681",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deanna L Mumford, PT
• Holly Noel Muntean
• Krystal Murphy, RBT
• Trinity Murphy, RBT
• Shakirah Mussington
• Teresa Lynn Mylan
• Paul Mysliwiec
• Lindsey Nauman Kaleel, PT
• Jaclyn Nauman, RBT
• Jaden Nave, RBT

• Gastroenterology Physician in Dixon, IL
• Providers in Dixon, IL by specialty
• Gastroenterology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; 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.

Verify at the official NPI Registry.