Individual provider Active NPI

Edward D Fausel, MD

  • Anesthesiology Physician
  • Rockford, IL
National Provider Identifier
1790745289
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Practice address
2400 N Rockton Ave
Rockford, IL 61103-3655
Phone
(815) 971-5000
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

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

2400 N Rockton Ave
Rockford, IL 61103-3655

Mailing address

6785 Weaver Rd
Ste D
Rockford, IL 61114-8055
Phone (815) 633-2225

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
I20111206000059 IL Practitioner - Anesthesiology 9234304106 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Vermont College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rockford Health PhysiciansGroup PAC ID 2567374036, 520 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

2400 N Rockton Ave
Rockford, IL 61103-3655
Phone (815) 971-5000

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians Anesthesiology CurrentSince Oct 11, 1997 Accepting new patients
Carle Health Care Incorporated Anesthesiology CurrentSince Aug 28, 2024 Accepting new patients
Clinical Colleagues LLC Anesthesiology CurrentSince Jul 1, 2022 Accepting new patients
Clinical Colleagues LLC Anesthesiology CurrentSince Jul 1, 2022 Accepting new patients
Associated Anesthesiologists, S.C. Anesthesiology CurrentSince Jan 30, 2023 Accepting new patients
RMH Pathologists, LTD Current Accepting new patients
Rockford Health Physicians CurrentSince Oct 11, 1997 Accepting new patients
Associated Anesthesiologists, SC Anesthesiology CurrentSince Jan 30, 2023 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

695 N Kellogg St
Galesburg, IL 61401
Phone (309) 343-8131

6742 N Frostwood Pkwy
Peoria, IL 61615
Phone (309) 692-5393

530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393

2701 17th St
Rock Island, IL 61201
Phone (309) 779-3200

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

6785 Weaver Rd
Ste D
Rockford, IL 61114
Phone (815) 633-8545

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: efauselmd422761@carlehiedirect.net

Organizations & group practices 8

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1790745289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6785 WEAVER RD",
            "address_2": "STE D",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611148055",
            "telephone_number": "815-633-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N ROCKTON AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033655",
            "telephone_number": "815-971-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUSEL",
        "first_name": "EDWARD",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.