Raymond G Maceren, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-115249 Issued in IL

Practice address

105 S First St
Wilmington, IL 60481-8973

Phone

(815) 476-5210

Fax

(815) 476-4193

NPI assigned

Aug 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Family Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Riverside Health SystemGroup PAC ID 3274434717, 202 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• R.M.C. Home Health Care Home health agency, Peotone, IL, CCN 147400
• Riverside Medical Center Hospital, Kankakee, IL, CCN 140186

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rmaceren7402@direct.riversidehealthcare.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Riverside Health System

  • General Practice Physician
  • Kankakee, IL
  • NPI 1417061193

  IL

  Medicare reassignment Care Compare group NPD
• Riverside Health System

  • Psychiatry Physician
  • Kankakee, IL
  • NPI 1336354430
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Riverside Medical Center

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1538208210

  Hospital

  Care Compare affiliation
• Riverside Medical Center

  • Home Health Agency
  • Peotone, IL
  • NPI 1740346451
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1891706503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S FIRST ST",
            "city": "WILMINGTON",
            "state": "IL",
            "postal_code": "604818973",
            "telephone_number": "815-476-5210",
            "fax_number": "815-476-4193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S FIRST ST",
            "city": "WILMINGTON",
            "state": "IL",
            "postal_code": "604818973",
            "telephone_number": "815-476-5210",
            "fax_number": "815-476-4193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACEREN",
        "first_name": "RAYMOND",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-115249",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036115249",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036115249",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shellee Marie Huffstutler, CNA
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• Island City Rehabilitation Center, LLC
• Annette M Jasso
• Lund Therapy and Coaching LLC
• Erin Malinowski
• Julie Mitchell
• Gina Marie Morgan, PHARMD
• Hope O'Keefe, APN-C
• Joan Papes, PT

• All providers in Wilmington, IL
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.