Individual provider Active NPI

Witold Rybicki, MD

  • Anesthesiology Physician
  • Hopedale, IL
National Provider Identifier
1760684161
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Practice address
107 Tremont
Hopedale Medical Complex
Hopedale, IL 61747
Phone
(309) 449-3321
Fax
(309) 449-5441
NPI assigned
Jun 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X IL Primary

Addresses

Primary practice location

107 Tremont
Hopedale Medical Complex
Hopedale, IL 61747

Mailing address

1002 Twin Lake Road
Bloomington, IL 61704
Phone (309) 829-5566

Other identifiers 1

IdentifierTypeStateIssuer
L82228OtherPIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036051775ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri County Anesthesia S.C. Anesthesiology Past Accepting new patients
McLean County Anesthesiology, LTD. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760684161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 TWIN LAKE ROAD",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "61704",
            "telephone_number": "309-829-5566",
            "fax_number": "309-827-3705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 TREMONT",
            "address_2": "HOPEDALE MEDICAL COMPLEX",
            "city": "HOPEDALE",
            "state": "IL",
            "postal_code": "61747",
            "telephone_number": "309-449-3321",
            "fax_number": "309-449-5441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYBICKI",
        "first_name": "WITOLD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN",
            "identifier": "L82228",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopedale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.