Individual provider Active NPI

Robb V Rydzynski, D.O.

  • Obstetrics & Gynecology Physician
  • Dixon, IL
National Provider Identifier
1720016306
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036-116183 Issued in IL
Practice address
215 E. 1St Street
Suite 215
Dixon, IL 61021
Phone
(815) 288-7711
Fax
(815) 285-8930
NPI assigned
Jun 30, 2006
Last updated
Aug 22, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036-116183 IL Primary

Addresses

Primary practice location

215 E. 1St Street
Suite 215
Dixon, IL 61021

Mailing address

215 E 1St St
Suite 215
Dixon, IL 61021-3166
Phone (815) 288-7711

Other identifiers 3

IdentifierTypeStateIssuer
K29795OtherILMEDICARE
036-116183OtherILLICENSE NUMBER
036116183MedicaidIL

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
I20060803000423 IL Practitioner - Obstetrics/Gynecology 9436162708 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morrison Community Hospital DistrictGroup PAC ID 2466349907, shared by 6 NPIs, 40 clinicians

Practice addresses (Care Compare)

303 N Jackson St
Morrison, IL 61270-3042
Phone (815) 772-4003

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-116183ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Morrison Community Hospital District Current Accepting new patients
Morrison Community Hospital District CurrentSince Apr 1, 2022 Accepting new patients
Morrison Community Hospital District CurrentSince Apr 1, 2022 Accepting new patients
CGH Medical Center Past Accepting new patients

Locations

303 N Jackson St
Morrison, IL 61270
Phone (815) 772-4003

657 W Lincolnway
Morrison, IL 61270
Phone (815) 772-4003

Interoperability endpoints

  • Direct secure messaging: robbrydzynski@mchospital.medalliesdirect.net

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 3

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1720016306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E 1ST ST",
            "address_2": "SUITE 215",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213166",
            "telephone_number": "815-288-7711",
            "fax_number": "815-285-8930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E. 1ST STREET",
            "address_2": "SUITE 215",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "61021",
            "telephone_number": "815-288-7711",
            "fax_number": "815-285-8930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDZYNSKI",
        "first_name": "ROBB",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-116183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K29795",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "036-116183",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036116183",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

Verify at the official NPI Registry.