NPIMap

Individual provider Active NPI

Arun Jacob, MD

  • Hospitalist Physician
  • La Grange, IL
National Provider Identifier
1720608011
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
036165367 Issued in IL
Practice address
1325 Community Memorial Dr
La Grange, IL 60525-2659
Phone
(708) 245-8900
Fax
(708) 245-5721
NPI assigned
Apr 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hospitalist Physician 208M00000X 036165367 IL Primary

Addresses

Primary practice location

1325 Community Memorial Dr
La Grange, IL 60525-2659

Mailing address

1325 Community Memorial Dr
La Grange, IL 60525-2659
Phone (708) 245-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230808002827 IL Practitioner - Hospitalist 8325462781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1 Kish Hospital Dr
Dekalb, IL 60115-9602
Phone (815) 756-1521

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036165367ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Hospitalist CurrentSince Aug 1, 2023 Accepting new patients
Central Dupage Physician Group CurrentSince Aug 1, 2023 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

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

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 2

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 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1720608011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 COMMUNITY MEMORIAL DR",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605252659",
            "telephone_number": "708-245-8900",
            "fax_number": "708-245-5721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 COMMUNITY MEMORIAL DR",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605252659",
            "telephone_number": "708-245-8900",
            "fax_number": "708-245-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "ARUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-16",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036165367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange, IL

Sources for this page

Verify at the official NPI Registry.