Individual provider Active NPI

Jeanine Alyce Baqai, MD

  • Ophthalmology Physician
  • Chicago, IL
National Provider Identifier
1518126184
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036130994 Issued in IL
Practice address
680 N Lake Shore Dr
Northwestern Medical Faculty Foundation Suite 1000
Chicago, IL 60611-3092
Phone
(312) 695-0665
Fax
(312) 695-0665
NPI assigned
Jun 8, 2008
Last updated
Jul 22, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036130994 IL Primary

Addresses

Primary practice location

680 N Lake Shore Dr
Northwestern Medical Faculty Foundation Suite 1000
Chicago, IL 60611-3092

Mailing address

680 N Lake Shore Dr
Northwestern Medical Faculty Foundation Suite 1000
Chicago, IL 60611-3092
Phone (312) 695-0665

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
I20121003000284 IL Practitioner - Ophthalmology 1254519622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Rush Medical College of Rush University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1630 Sherman Ave
Evanston, IL 60201-3711

251 E Huron
Chicago, IL 60611-2908

251 E Huron St
Chicago, IL 60611-2908

259 E Erie St
Chicago, IL 60611-2930
Phone (312) 503-1944

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery140

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036130994ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Feb 16, 2015 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Feb 16, 2015 Accepting new patients
Central Dupage Physician Group Past Accepting new patients
Ophthalmology Associates LTD Ophthalmology Past Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

251 E Huron St
#16
Chicago, IL 60611

259 E Erie St
Ste 1520
Chicago, IL 60611
Phone (312) 503-3649

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

1630 Sherman Ave
Ste 100
Evanston, IL 60201
Phone (224) 271-4860

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 4

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 1

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": "1212883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437523200000",
    "number": "1518126184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "NORTHWESTERN MEDICAL FACULTY FOUNDATION SUITE 1000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113092",
            "telephone_number": "312-695-0665",
            "fax_number": "312-695-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "NORTHWESTERN MEDICAL FACULTY FOUNDATION SUITE 1000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113092",
            "telephone_number": "312-695-0665",
            "fax_number": "312-695-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAQAI",
        "first_name": "JEANINE",
        "middle_name": "ALYCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-08",
        "last_updated": "2015-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036130994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.