Individual provider Active NPI

Jason Reter, D.O.

  • Family Medicine Physician
  • Sterling, IL
National Provider Identifier
1902856859
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036103279 Issued in IL
Practice address
100 E Le Fevre Rd
Sterling, IL 61081-1278
Phone
(815) 625-0400
Fax
(815) 625-6728
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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 036103279 IL Primary

Addresses

Primary practice location

100 E Le Fevre Rd
Sterling, IL 61081-1278

Mailing address

100 E Le Fevre Rd
Sterling, IL 61081-1278
Phone (815) 625-0400

Other identifiers 2

IdentifierTypeStateIssuer
P00215024OtherRAILROAD MEDICARE
318403199001MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jason.reter.p1@direct.cghmc.nextgenshare.com

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
I20040628000858 IL Practitioner - Family Practice 7416933650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Chicago College of Osteopathy, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CGH Medical CenterGroup PAC ID 6103723267, 199 clinicians

Practice addresses (Care Compare)

101 E Miller Rd
Sterling, IL 61081-1252
Phone (815) 625-4790

3010 E Lynn Blvd
Sterling, IL 61081-1717
Phone (815) 625-6750

601 E Old Mill St
Milledgeville, IL 61051-9221
Phone (815) 225-6040

Hospital & facility affiliations

  • CGH Home Nursing Home health agency, Sterling, IL, CCN 147562
  • Gaffey Home Nursing & Hospice, Inc Home health agency, Sterling, IL, CCN 147503
  • Rock River Hospice and Home Hospice, Sterling, IL, CCN 141552
  • CGH Medical Center Hospital, Sterling, IL, CCN 140043
  • Osf Saint Katharine Medical Center Hospital, Dixon, IL, CCN 140012
  • Citadel of Sterling,the Nursing home, Sterling, IL, CCN 145278

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036103279ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CGH Medical Center Current Accepting new patients
CGH Medical Center CurrentSince Jan 1, 2014 Accepting new patients
CGH Medical Center Family Medicine CurrentSince Jan 1, 2014 Accepting new patients
Rock River Health, Inc. Family Medicine Past Accepting new patients

Locations

711 S Division Ave
Polo, IL 61064
Phone (815) 946-3661

3010 E Lynn Blvd
Sterling, IL 61081
Phone (815) 622-0836

10 W 3rd St
Sterling, IL 61081
Phone (815) 226-4990

100 E Lefevre Rd
Sterling, IL 61081
Phone (815) 625-0400

101 E Miller Rd
Sterling, IL 61081
Phone (815) 632-5285

Interoperability endpoints

  • Direct secure messaging: jreter20113@cghmc.direct-ci.com

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 and National Provider Directory roles.

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1902856859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LE FEVRE RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811278",
            "telephone_number": "815-625-0400",
            "fax_number": "815-625-6728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LE FEVRE RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811278",
            "telephone_number": "815-625-0400",
            "fax_number": "815-625-6728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETER",
        "first_name": "JASON",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036103279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00215024",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318403199001",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jason.reter.p1@direct.cghmc.nextgenshare.com",
            "affiliation": "N",
            "address_1": "100 E Le Fevre Rd",
            "city": "Sterling",
            "state": "IL",
            "country_code": "US",
            "postal_code": "610811278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sterling, IL

Sources for this page

Verify at the official NPI Registry.