Individual provider Active NPI

Michael James Polizzotto, M.D.

  • Family Medicine Physician
  • Rockford, IL
National Provider Identifier
1871595371
Registry record updated Sep 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36113709 Issued in IL
Practice address
1221 E State St
Rockford, IL 61104-2231
Phone
(815) 972-1000
NPI assigned
Aug 15, 2005
Last updated
Sep 8, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36113709 IL Primary

Addresses

Primary practice location

1221 E State St
Rockford, IL 61104-2231

Mailing address

1221 E State St
Rockford, IL 61104-2231
Phone (815) 972-1000

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
I20050701000103 IL Practitioner - Family Practice 9739125592 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Vermont College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

1401 E State St
Rockford, IL 61104-2315
Phone (815) 489-4400

1700 Henry Luckow LN
Belvidere, IL 61008-1702
Phone (779) 696-8650

2909 N Main St
Rockford, IL 61103-3100
Phone (779) 696-5000

3505 N Bell School Rd
Rockford, IL 61114-6624
Phone (779) 696-0300

3535 N Bell School Rd
Regional Cancer Center
Rockford, IL 61114-6624
Phone (779) 696-9400

6824 Newburg Rd
Sa Valley
Rockford, IL 61108-4330
Phone (779) 696-7610

815 Marchesano Dr
Rockford, IL 61102-3521
Phone (779) 696-5950

Hospital & facility affiliations

  • Uw Health Hospital, Rockford, IL, CCN 140228

Merit-based Incentive Payment System (MIPS)

Final score
81.51 of 100Reported as group
Quality
83.2
Promoting interoperability
77
Improvement activities
40
Cost
71.7

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36113709ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Oct 3, 2005 Accepting new patients
Swedishamerican Hospital CurrentSince Jan 3, 2022 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Oct 3, 2005 Accepting new patients
Swedishamerican Hospital Family Medicine CurrentSince Jan 3, 2022 Accepting new patients
The Board of Trustees of the University of Illinois Family Medicine Past Accepting new patients

Locations

2170 Pearl St
Belvidere, IL 61008
Phone (815) 395-5886

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

405 Charles St
Mount Morris, IL 61054
Phone (815) 395-5860

1221 E State St
Rockford, IL 61104
Phone (815) 972-1000

1601 Parkview Ave
Rockford, IL 61107
Phone (815) 395-0600

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

1511 N Blackhawk Blvd
Rockton, IL 61072
Phone (815) 395-5879

Interoperability endpoints

  • Direct secure messaging: mpolizzotto17627@uihealth.direct-ci.com

Organizations & group practices 6

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 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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315440000000",
    "number": "1871595371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042231",
            "telephone_number": "815-972-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042231",
            "telephone_number": "815-972-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLIZZOTTO",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2011-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "36113709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.