Individual provider Active NPI

Scott R Homann, M.D.

  • Infectious Disease Physician
  • Rockford, IL
National Provider Identifier
1689674541
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
036069323 Issued in IL
Practice address
1340 Charles St Ste 404
Rockford, IL 61104-2200
Phone
(779) 696-1890
Fax
(779) 696-5898
NPI assigned
Jul 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 036-069323 IL
Infectious Disease Physician 207RI0200X 036069323 IL Primary

Addresses

Primary practice location

1340 Charles St Ste 404
Rockford, IL 61104-2200

Mailing address

PO Box 78866
Milwaukee, WI 53278-8866
Phone (779) 696-7150

Other practice location 1

129 Phelps Ave
Suite 508
Rockford, IL 61108-2453
Phone (815) 229-2300

Other identifiers 1

IdentifierTypeStateIssuer
036-069323MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shomann911997@direct.uwhealth.org

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
I20040723000357 IL Practitioner - Infectious DiseasePractitioner - Internal Medicine 0345220919 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Northwestern University Feinberg Medical School, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crusaders Central Clinic AssociationGroup PAC ID 5799682993, 31 clinicians
Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

1200 W State St
Rockford, IL 61102-2112
Phone (815) 490-1600

1340 Charles St
Rockford, IL 61104-2200

1401 E State St
Rockford, IL 61104-2315
Phone (815) 489-4400

2601 N Main St
Sa North Main
Rockford, IL 61103-3110
Phone (779) 696-8350

6824 Newburg Rd
Sa Valley
Rockford, IL 61108-4330
Phone (779) 696-7610

Hospital & facility affiliations

  • Uw Health Hospital, Rockford, IL, CCN 140228

Merit-based Incentive Payment System (MIPS)

Final score
81.51 of 100Reported as group
Quality
83.2
Promoting interoperability
77
Improvement activities
40
Cost
71.7

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue14
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-069323ILMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Crusaders Central Clinic Association CurrentSince Aug 18, 2010 Accepting new patients
Swedishamerican Hospital Current Accepting new patients
Swedishamerican Hospital CurrentSince Dec 1, 2017 Accepting new patients
Swedishamerican Hospital CurrentSince Dec 1, 2017 Accepting new patients
Crusaders Central Clinic Association Current Accepting new patients

Locations

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

1340 Charles St
Ste 404
Rockford, IL 61104
Phone (815) 316-8346

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

1200 W State St
Rockford, IL 61102

Interoperability endpoints

  • Direct secure messaging: shomann911997@direct.uwhealth.org

Organizations & group practices 5

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": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1689674541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78866",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532788866",
            "telephone_number": "779-696-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 CHARLES ST STE 404",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042200",
            "telephone_number": "779-696-1890",
            "fax_number": "779-696-5898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "129 Phelps Ave",
            "address_2": "Suite 508",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611082453",
            "country_code": "US",
            "telephone_number": "815-229-2300",
            "fax_number": "815-229-3909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOMANN",
        "first_name": "SCOTT",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-069323",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": "036069323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-069323",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shomann911997@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "1340 Charles St Ste 404",
            "city": "Rockford",
            "state": "IL",
            "country_code": "US",
            "postal_code": "611042200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.