Individual provider Active NPI

Edward Andrew Telfer, M.D.

  • Cardiovascular Disease Physician
  • Rockford, IL
National Provider Identifier
1700805249
Registry record updated Nov 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
36081182 Issued in IL
Practice address
444 Roxbury Road
Rockford, IL 61107-5059
Phone
(815) 398-3000
Fax
(815) 398-3041
NPI assigned
Jul 18, 2006
Last updated
Nov 12, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2009

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 36081182 IL Primary
Clinical Cardiac Electrophysiology Physician 207RC0001X 36081182 IL
Body Imaging Physician 2085B0100X 36081182 IL
Diagnostic Ultrasound Physician 2085U0001X 36081182 IL

Addresses

Primary practice location

444 Roxbury Road
Rockford, IL 61107-5059

Mailing address

PO Box 6003
Rockford, IL 61126-6003
Phone (815) 398-3000

Other identifiers 3

IdentifierTypeStateIssuer
CB0709/P00149580OtherGARR MEDICARE GROUP#/PIN
036081182 1MedicaidIL
101 15504OtherILB/C B/S OF ILLINOIS

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
I20040702000956 IL Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 9133106552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Michigan Medical School, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

444 Roxbury Rd
Rockford, IL 61107-5059
Phone (815) 398-3000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36081182ILMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
Cardiac Arrhythmia Consultants, LTD Clinical Cardiac Electrophysiology Past Accepting new patients
Rockford Cardiology Associates, LTD Cardiovascular Disease Past Accepting new patients

Locations

1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

444 Roxbury Rd
Rockford, IL 61107
Phone (815) 395-9196

5668 E State St
Ste 2500
Rockford, IL 61108
Phone (812) 398-3000

1850 Gateway Dr
Sycamore, IL 60178
Phone (815) 217-3252

Organizations & group practices 4

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.

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257984000000",
    "number": "1700805249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6003",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611266003",
            "telephone_number": "815-398-3000",
            "fax_number": "815-391-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 ROXBURY ROAD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075059",
            "telephone_number": "815-398-3000",
            "fax_number": "815-398-3041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELFER",
        "first_name": "EDWARD",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2009-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "36081182",
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "IL",
            "license": "36081182",
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "IL",
            "license": "36081182",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "IL",
            "license": "36081182",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP#/PIN",
            "identifier": "CB0709/P00149580",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036081182 1",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B/C B/S OF ILLINOIS",
            "identifier": "101 15504",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.