Individual provider Active NPI

Jolene K Manuyag

  • Family Nurse Practitioner
  • Hinsdale, IL
National Provider Identifier
1790313674
Registry record updated Mar 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209020785 Issued in IL
Practice address
12 Salt Creek LN Ste 425
Hinsdale, IL 60521-8603
Phone
(312) 848-3533
NPI assigned
Mar 27, 2020
Last updated
Mar 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209020785 IL Primary

Addresses

Primary practice location

12 Salt Creek LN Ste 425
Hinsdale, IL 60521-8603

Mailing address

12 Salt Creek LN Ste 425
Hinsdale, IL 60521-8603
Phone (630) 789-2260

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201001002411 IL Practitioner - Nurse Practitioner 6709205255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Illinois Gastroenterology Group LLCGroup PAC ID 5193857423, 116 clinicians

Practice addresses (Care Compare)

12 Salt Creek LN
Suite 425
Hinsdale, IL 60521-8603
Phone (630) 789-2260

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.21 of 100Reported as group
Quality
67.65
Promoting interoperability
99
Improvement activities
40
Cost
80.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hinsdale Gastroenterology Associates, SC CurrentSince Apr 5, 2020 Accepting new patients
Illinois Gastroenterology Group, LLC CurrentSince Sep 3, 2020 Accepting new patients
Northwest Gastroenterologists SC Current Accepting new patients
Elgin Gastroenterology SC Current Accepting new patients
Elgin Gastroenterology Endoscopy Center LLC Current Accepting new patients

Locations

745 Fletcher Dr
Ste 202
Elgin, IL 60123
Phone (855) 483-7362

12 Salt Creek Ln
Ste 425
Hinsdale, IL 60521
Phone (630) 789-2260

2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246

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, 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": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585353600000",
    "number": "1790313674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 SALT CREEK LN STE 425",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605218603",
            "telephone_number": "630-789-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 SALT CREEK LN STE 425",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605218603",
            "telephone_number": "312-848-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANUYAG",
        "first_name": "JOLENE K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2020-03-28",
        "certification_date": "2020-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209020785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

Verify at the official NPI Registry.