Nusaybah Ismail

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085-005644 Issued in IL

Practice address

9000 Waukegan Rd
Suite 200
Morton Grove, IL 60053-2127

Phone

(847) 375-3000

NPI assigned

Sep 21, 2015

Last updated

Sep 21, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ottumwa Health Group LLCGroup PAC ID 3971629924, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ottumwa Regional Health Center Hospital, Ottumwa, IA, CCN 160089
• Mercyone Centerville Medical Center Hospital, Centerville, IA, CCN 161377

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ottumwa Health Group LLC

  • Gynecology Physician
  • Ottumwa, IA
  • NPI 1386956290
  Medicare reassignment Care Compare group NPD (past)
• Ottumwa Health Group LLC

  dba Ottumwa Women's Health Clinic

  • Rural Health Clinic/Center
  • Ottumwa, IA
  • NPI 1336919364
  NPD

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

• Mercy Medical Center-Centerville

  dba Mercyone Centerville Medical Center

  • Critical Access Hospital
  • Centerville, IA
  • NPI 1356391635
  Care Compare affiliation
• RCHP Ottumwa LLC

  dba Ottumwa Regional Health Center

  • General Acute Care Hospital
  • Ottumwa, IA
  • NPI 1013233741
  Care Compare affiliation

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1679942601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RAND RD",
            "address_2": "SUITE 300",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162359",
            "telephone_number": "847-324-3976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 WAUKEGAN RD",
            "address_2": "SUITE 200",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532127",
            "telephone_number": "847-375-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISMAIL",
        "first_name": "NUSAYBAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-21",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-005644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Illinois Bone and Joint Institute, LLC
• Illinois Bone and Joint Institute, LLC
• Illinois Sports Medicine & Orthopedic Surgery Center, LLC
• Elizabeth Owole Ilo
• Irina Bolotnikov DDS PC
• Marko J Jachtorowycz, M.D.
• Julie Marie Jacobs, APN-CNP
• Judith Whitford James, FNP-BC
• Lukasz Jarosinski, PTA
• Tetiana Anna Jastrembsky

• Physician Assistant in Morton Grove, IL
• Providers in Morton Grove, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; 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.