Individual provider Active NPI

Jibril Ashiru-Balogun, MD

  • Emergency Medicine Physician
  • Newark, NJ
National Provider Identifier
1669047551
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MA12329500 Issued in NJ
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

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
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, WI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20241011001240 NJ Practitioner - Emergency Medicine 8123550449 Reassigns benefits to 2 organizations
I20251008001530 IL Practitioner - Emergency Medicine 8123550449 Reassigns benefits to 3 organizations
I20251023003735 WI Practitioner - Emergency Medicine 8123550449 Reassigns benefits to 2 organizations

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
Rockford Health PhysiciansGroup PAC ID 2567374036, 520 clinicians

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

LicenseStateTypeSpecialty
036.176827ILMDEmergency Medicine Physician
25MA12329500NJMDEmergency Medicine Physician
85833-20WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Observation Associates LLC Emergency Medicine CurrentSince Jul 29, 2024 Accepting new patients
Rwjbh Emergency Medicine Associates, LLC Emergency Medicine CurrentSince Jul 29, 2024 Accepting new patients
Mercy Harvard Hospital Inc CurrentSince Dec 1, 2025 Accepting new patients
Rockford Health Physicians CurrentSince Aug 26, 2025 Accepting new patients
Mercy Harvard Hospital Inc CurrentSince Dec 1, 2025 Accepting new patients
Mercy Health System Corporation Current Accepting new patients
Mercy Health System Corporation CurrentSince Aug 18, 2025 Accepting new patients
Mercy Health System Corporation CurrentSince Aug 18, 2025 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

  • Direct secure messaging: 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.

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": "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

Verify at the official NPI Registry.