Active NPI
Rujuta Gore
- Ophthalmology Physician
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 036.161999
- Practice address
- 4927 N Glen Park Place Rd
Peoria, IL 61614-4676 - Phone
- (309) 308-3500
- NPI assigned
- Mar 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 036.161999 | IL | Primary |
| Pediatric Ophthalmology and Strabismus Specialist Physician | 207WX0110X | 036.161999 | IL |
Addresses
Primary practice location
4927 N Glen Park Place Rd
Peoria, IL 61614-4676
Mailing address
4927 N Glen Park Place Rd
Peoria, IL 61614-4676
Phone (309) 308-3500
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Illini Dr
Peoria, IL 61605-2576
Phone (309) 671-3173
Hospital & facility affiliations
- Saint Francis Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.28 of 100
- Quality
- 73.53
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.73
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.161999 | IL | MD | Pediatric Ophthalmology and Strabismus Specialist Physician Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osf Multi-Specialty Group | Current | Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| Board of Trustees of the University of Illinois | Current | Accepting new patients |
Locations
7694 Solutions Ctr
Chicago, IL 60677
3315 N Seminary St
Galesburg, IL 61401
Phone (309) 344-1000
1 Illini Dr
Peoria, IL 61605
Phone (309) 671-3000
1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553
4927 N Glen Park Place Rd
Peoria, IL 61614
Phone (309) 308-3500
Interoperability endpoints
- rgore537474@direct.hopkinsmedicine.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.
-
- Anatomic Pathology Physician
- Chicago, IL
- NPI 1386863819
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
- Pediatrics Physician
- Peoria, IL
- NPI 1467425322
-
- Occupational Medicine Physician
- Chicago, IL
- NPI 1043727571
-
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664582400000",
"number": "1720546559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4927 N GLEN PARK PLACE RD",
"city": "PEORIA",
"state": "IL",
"postal_code": "616144676",
"telephone_number": "309-308-3500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4927 N GLEN PARK PLACE RD",
"city": "PEORIA",
"state": "IL",
"postal_code": "616144676",
"telephone_number": "309-308-3500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORE",
"first_name": "RUJUTA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-11",
"last_updated": "2022-10-01",
"certification_date": "2022-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IL",
"license": "036.161999",
"primary": true
},
{
"code": "207WX0110X",
"taxonomy_group": "",
"desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
"state": "IL",
"license": "036.161999",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2022; 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.