NPIMap

Individual provider Active NPI

Madeline Rosenbaum

  • Physician Assistant
  • Libertyville, IL
National Provider Identifier
1821512997
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.006254 Issued in IL
Practice address
1800 Hollister Dr Ste 112
Libertyville, IL 60048-5265
Phone
(847) 367-6781
Fax
(847) 367-8008
NPI assigned
Jul 31, 2017
Last updated
Nov 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.006254 IL Primary

Addresses

Primary practice location

1800 Hollister Dr Ste 112
Libertyville, IL 60048-5265

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

120 Spalding Dr Ste 205
Naperville, IL 60540-6527
Phone (630) 646-6020

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mrosenbaum409653@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20180423001598 IL Practitioner - Physician Assistant 4082977277 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

801 S Milwaukee Ave
Libertyville, IL 60048-3204
Phone (847) 279-0061

801 S Milwaukee Ave BLDG
Suite 880
Libertryville, IL 60048-3204
Phone (847) 990-5910

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

Merit-based Incentive Payment System (MIPS)

Final score
99.02 of 100Reported as apm
Quality
85.37
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.006254ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Nov 30, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Mar 5, 2018 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Mar 5, 2018 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Sep 7, 2024 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Sep 7, 2024 Accepting new patients
Edward Health Ventures CurrentSince May 31, 2021 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

Dept 5777
Carol Stream, IL 60122

251 E Huron St
Chicago, IL 60611

29373 Network Pl
Chicago, IL 60673

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

1800 Hollister Dr
Ste 112
Libertyville, IL 60048
Phone (708) 367-6781

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

120 Spalding Dr
Ste 205
Naperville, IL 60540
Phone (630) 527-5217

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

Interoperability endpoints

  • Direct secure messaging: mrosenbaum409653@direct.myadvocateaurora.org

Organizations & group practices 7

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": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1821512997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 HOLLISTER DR STE 112",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485265",
            "telephone_number": "847-367-6781",
            "fax_number": "847-367-8008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Spalding Dr Ste 205",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605406527",
            "country_code": "US",
            "telephone_number": "630-646-6020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSENBAUM",
        "first_name": "MADELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.006254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrosenbaum409653@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1800 Hollister Dr Ste 112",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600485265",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1800 Hollister Dr Ste 112",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600485265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.