Individual provider Active NPI

Andrzej M Jasek, MD

  • Rheumatology Physician
  • Rockford, IL
National Provider Identifier
1578636692
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
036-092808 Issued in IL
Practice address
5875 E Riverside Blvd
Rockford, IL 61114-4937
Phone
(815) 398-9491
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 41875 WI
Rheumatology Physician 207RR0500X 036-092808 IL Primary

Addresses

Primary practice location

5875 E Riverside Blvd
Rockford, IL 61114-4937

Mailing address

PO Box 735263
Chicago, IL 60673-5263

Other identifiers 2

IdentifierTypeStateIssuer
32287100MedicaidWI
036092808 1MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Jasek.Andrew@ro.eclinicaldirect.com Direct

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
I20050124000916 IL Practitioner - RheumatologyPractitioner - Internal Medicine 6103876529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthomidwest, PLLCGroup PAC ID 0749183713, 531 clinicians

Practice addresses (Care Compare)

1550 N Randall Rd
Elgin, IL 60123-7876
Phone (815) 398-9491

5875 E Riverside Blvd
Rockford, IL 61114-4937
Phone (815) 398-9491

770 Beloit Rd
Belvidere, IL 61008-1745
Phone (815) 398-9491

Hospital & facility affiliations

  • Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233
  • Uw Health Hospital, Rockford, IL, CCN 140228
  • Osf Saint Katharine Medical Center Hospital, Dixon, IL, CCN 140012
  • Rochelle Community Hospital Hospital, Rochelle, IL, CCN 141312
  • FHN Memorial Hospital Hospital, Freeport, IL, CCN 140160

Merit-based Incentive Payment System (MIPS)

Final score
84.02 of 100Reported as group
Quality
68.63
Promoting interoperability
100
Improvement activities
40
Cost
78.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-092808ILMDRheumatology Physician
41875WIMDRheumatology Physician

Interoperability endpoints

  • Direct secure messaging: andrew.jasek@ro.eclinicaldirectplus.com
  • Direct secure messaging: jasek.andrew@ro.eclinicaldirect.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 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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1578636692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735263",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 E RIVERSIDE BLVD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611144937",
            "telephone_number": "815-398-9491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASEK",
        "first_name": "ANDRZEJ",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WI",
            "license": "41875",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IL",
            "license": "036-092808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32287100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036092808 1",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jasek.Andrew@ro.eclinicaldirect.com",
            "affiliation": "N",
            "endpointDescription": "eCW email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5875 E Riverside Blvd",
            "city": "Rockford",
            "state": "IL",
            "country_code": "US",
            "postal_code": "611144937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.