NPIMap

Individual provider Active NPI

Jayashree T. Gowda, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Moline, IL
National Provider Identifier
1811334485
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036148094 Issued in IL
Practice address
612 35TH Ave
Moline, IL 61265-6176
Phone
(309) 788-0014
Fax
(309) 623-4638
NPI assigned
May 23, 2013
Last updated
Jun 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036148094 IL Primary

Addresses

Primary practice location

612 35TH Ave
Moline, IL 61265-6176

Mailing address

612 35TH Ave
Moline, IL 61265-6176
Phone (309) 788-0014

Other practice location 1

1989 Spruce Hills Dr
Bettendorf, IA 52722-2624
Phone (563) 293-3131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190327002240 IL Practitioner - Endocrinology 1951532365 Reassigns benefits to 1 organization
I20220420001603 IA Practitioner - Endocrinology 1951532365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Genesis Health SystemGroup PAC ID 6103829338, shared by 2 NPIs, 262 clinicians

Practice addresses (Care Compare)

2535 Maplecrest Rd
Suite 10
Bettendorf, IA 52722-2799
Phone (563) 421-4620

612 35TH Ave
Moline, IL 61265-6176
Phone (309) 281-6410

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
34.85 of 100Reported as group
Quality
21.4
Improvement activities
0
Cost
76.92

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Health System CurrentSince Mar 1, 2024 Accepting new patients
Genesis Health System CurrentSince Mar 1, 2024 Accepting new patients
Genesis Health System Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

2535 Maplecrest Rd
Ste 10
Bettendorf, IA 52722
Phone (319) 344-3500

865 Lincoln Rd
Ste 100
Bettendorf, IA 52722
Phone (563) 355-1000

1351 W Central Park Ave
Ste 4100
Davenport, IA 52804
Phone (563) 355-9191

4700 E 56th St
Ste 100
Davenport, IA 52807
Phone (563) 383-2667

612 35th Ave
Moline, IL 61265
Phone (309) 764-6767

612 35th Ave
Ste 1
Moline, IL 61265
Phone (309) 788-0014

801 Illini Dr
Silvis, IL 61282
Phone (309) 281-4000

Organizations & group practices 4

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 6

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": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1811334485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 35TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656176",
            "telephone_number": "309-788-0014",
            "fax_number": "309-623-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 35TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656176",
            "telephone_number": "309-788-0014",
            "fax_number": "309-623-4638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1989 Spruce Hills Dr",
            "address_purpose": "LOCATION",
            "city": "Bettendorf",
            "state": "IA",
            "postal_code": "527222624",
            "country_code": "US",
            "telephone_number": "563-293-3131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOWDA",
        "first_name": "JAYASHREE",
        "middle_name": "T.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-23",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036148094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

Verify at the official NPI Registry.