Individual provider Active NPI

Jamal Mosabbeh, CRNA

  • Certified Registered Nurse Anesthetist
  • McHenry, IL
National Provider Identifier
1861410771
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209016788 Issued in IL
Practice address
4201 W Medical Center Dr
McHenry, IL 60050-8409
Phone
(815) 344-5000
Fax
(815) 344-3347
NPI assigned
Jul 18, 2006
Last updated
Dec 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209016788 IL Primary

Addresses

Primary practice location

4201 W Medical Center Dr
McHenry, IL 60050-8409

Mailing address

4201 W Medical Center Dr
McHenry, IL 60050-8409
Phone (815) 344-5000

Other identifiers 3

IdentifierTypeStateIssuer
214881OtherILMEDICARE MULTISPECIALTY GROUP PTAN
8051601MedicaidNC
P00603483OtherNCRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmosabbeh36224@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, IL, WI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20050314000142 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608821632 Reassigns benefits to 1 organization
I20191112000207 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608821632 Reassigns benefits to 9 organizations
I20250319001705 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608821632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ias Illinois PCGroup PAC ID 9638530991, 79 clinicians

Practice addresses (Care Compare)

1969 W Hart Rd
Beloit, WI 53511-2230
Phone (608) 364-5011

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
209016788ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ashland Medical Specialist Inc CurrentSince Feb 13, 2025 Accepting new patients
The Pain Center of Illinois Inc. CurrentSince Feb 13, 2025 Accepting new patients
Ias Illinois PC CurrentSince Feb 1, 2025 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2021 Accepting new patients
Illinois Back & Neck Institute,PLLC CurrentSince Jan 4, 2025 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2021 Accepting new patients
Windy City Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Oct 10, 2023 Accepting new patients
G & G Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2023 Accepting new patients
North American Partners in Anesthesia (Illinois), LLC CurrentSince Jul 1, 2021 Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Nov 18, 2019 Accepting new patients
360 Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2023 Accepting new patients
Windy City Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Oct 10, 2023 Accepting new patients
Heritage Family Physicians Past Accepting new patients
Central Dupage Physician Group Past Accepting new patients
Anesthesia Network Services, LLC Past Accepting new patients
Durham Anesthesia Associates PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Cumberland County Hospital System Inc Past Accepting new patients

Locations

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

405 W Jackson St
Carbondale, IL 62901

Dept 5777
Carol Stream, IL 60122

1500 S Fairfield Ave
Chicago, IL 60608
Phone (773) 257-5701

4646 N Marine Dr
Chicago, IL 60640
Phone (773) 564-5102

300 W Butterfield Rd
Ste 102
Elmhurst, IL 60126

300 W Butterfield Rd
Ste 105
Elmhurst, IL 60126
Phone (630) 474-3735

21120 Washington Pkwy
Frankfort, IL 60423
Phone (815) 462-8470

2525 Kaneville Rd
Geneva, IL 60134
Phone (630) 584-1400

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

4201 W Medical Center Dr
McHenry, IL 60050
Phone (815) 759-3100

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

150 W High St
Morris, IL 60450
Phone (815) 942-2129

3 Erie Ct
Oak Park, IL 60302
Phone (708) 763-6200

12251 S 80th Ave
Palos Heights, IL 60463
Phone (708) 361-4500

10401 S Roberts Rd
Ste 2
Palos Hills, IL 60465
Phone (708) 430-1600

5605 E Rockton Rd
Roscoe, IL 61073
Phone (815) 525-4000

575 N River St
Wilkes Barre, PA 18764
Phone (570) 552-1300

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 1

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1861410771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 W MEDICAL CENTER DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508409",
            "telephone_number": "815-344-5000",
            "fax_number": "815-344-3347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 W MEDICAL CENTER DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508409",
            "telephone_number": "815-344-5000",
            "fax_number": "815-344-3347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSABBEH",
        "first_name": "JAMAL",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209016788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE MULTISPECIALTY GROUP PTAN",
            "identifier": "214881",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8051601",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00603483",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmosabbeh36224@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "405 W Jackson St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.