Active NPI
Jibril Ashiru-Balogun, MD
- Emergency Medicine Physician
- Newark, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 25MA12329500
- Practice address
- 201 Lyons Ave
Newark, NJ 07112-2027 - Phone
- (732) 557-2604
- NPI assigned
- May 24, 2021
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 85833-20 | WI | |
| Emergency Medicine Physician | 207P00000X | 036.176827 | IL | |
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 85833-20 | WI | |
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 036.176827 | IL | |
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 25MA12329500 | NJ | |
| Emergency Medicine Physician | 207P00000X | 25MA12329500 | NJ | Primary |
Addresses
Primary practice location
201 Lyons Ave
Newark, NJ 07112-2027
Mailing address
99 Highway 37 W
Toms River, NJ 08755-6423
Phone (732) 557-2604
Other practice location 1
1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000
Other practice location 2
875 S Route 31
Crystal Lake, IL 60014-8190
Phone (779) 220-5500
Other practice location 3
1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6868
Other practice location 4
901 Grant St
Harvard, IL 60033-1821
Phone (815) 943-5431
Other practice location 5
N2950 State Road 67
Lake Geneva, WI 53147-2655
Phone (262) 245-0535
Other practice location 6
8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ, IL, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-2000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.176827 | IL | MD | Emergency Medicine Physician |
| 25MA12329500 | NJ | MD | Emergency Medicine Physician |
| 85833-20 | WI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rwjbh Observation Associates LLC | Emergency Medicine | Current | Accepting new patients |
| Rwjbh Emergency Medicine Associates, LLC | Emergency Medicine | Current | Accepting new patients |
| Mercy Harvard Hospital Inc | Current | Accepting new patients | |
| Rockford Health Physicians | Current | Accepting new patients | |
| Mercy Harvard Hospital Inc | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients |
Locations
Carol Stream, IL 60122
29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652
875 S State Route 31
Crystal Lake, IL 60014
Phone (779) 220-5500
1045 W Stephenson St
Freeport, IL 61032
Phone (815) 599-6105
348 S Division St
Harvard, IL 60033
Phone (815) 943-1122
901 Grant St
Harvard, IL 60033
Phone (815) 943-5431
8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066
2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510
2350 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-2200
225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204
600 River Ave
Lakewood, NJ 08701
Phone (732) 363-1900
94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400
201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455
379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545
110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833
99 State Route 37 W
Toms River, NJ 08755
Phone (732) 240-8000
1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763
1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868
N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535
Interoperability endpoints
- jashirubalogun126854@direct.mhemail.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
- Rockford, IL
- NPI 1043242886
-
- Emergency Medicine Physician
- Somerset, NJ
- NPI 1912510041
-
- Emergency Medicine Physician
- Livingston, NJ
- NPI 1760095806
-
- Critical Access Hospital
- Harvard, IL
- NPI 1427001445
-
- Critical Access Hospital
- Lake Geneva, WI
- NPI 1699728550
-
- Skilled Nursing Facility
- Harvard, IL
- NPI 1124195557
-
- General Acute Care Hospital
- Janesville, WI
- NPI 1093768962
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Rockford, IL
- NPI 1629118609
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775606400000",
"number": "1669047551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 HIGHWAY 37 W",
"city": "TOMS RIVER",
"state": "NJ",
"postal_code": "087556423",
"telephone_number": "732-557-2604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 LYONS AVE",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071122027",
"telephone_number": "732-557-2604"
}
],
"practiceLocations": [
{
"address_1": "1045 W Stephenson St",
"address_purpose": "LOCATION",
"city": "Freeport",
"state": "IL",
"postal_code": "610324864",
"country_code": "US",
"telephone_number": "815-599-6000",
"fax_number": "815-599-7974",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "875 S Route 31",
"address_purpose": "LOCATION",
"city": "Crystal Lake",
"state": "IL",
"postal_code": "600148190",
"country_code": "US",
"telephone_number": "779-220-5500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1000 Mineral Point Ave",
"address_purpose": "LOCATION",
"city": "Janesville",
"state": "WI",
"postal_code": "535482940",
"country_code": "US",
"telephone_number": "608-756-6868",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "901 Grant St",
"address_purpose": "LOCATION",
"city": "Harvard",
"state": "IL",
"postal_code": "600331821",
"country_code": "US",
"telephone_number": "815-943-5431",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "N2950 State Road 67",
"address_purpose": "LOCATION",
"city": "Lake Geneva",
"state": "WI",
"postal_code": "531472655",
"country_code": "US",
"telephone_number": "262-245-0535",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8201 E Riverside Blvd",
"address_purpose": "LOCATION",
"city": "Rockford",
"state": "IL",
"postal_code": "611142300",
"country_code": "US",
"telephone_number": "815-971-7000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ASHIRU-BALOGUN",
"first_name": "JIBRIL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-24",
"last_updated": "2026-04-08",
"certification_date": "2026-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WI",
"license": "85833-20",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036.176827",
"primary": false
},
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "WI",
"license": "85833-20",
"primary": false
},
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "IL",
"license": "036.176827",
"primary": false
},
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "NJ",
"license": "25MA12329500",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NJ",
"license": "25MA12329500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.