Active NPI
Rubina Ehtesham, MD
- Internal Medicine Physician
- Rockford, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036103553
- Practice address
- 2400 N Rockton Ave
Rockford, IL 61103-3655 - Phone
- (815) 971-4025
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036103553 | IL | Primary |
| Hospitalist Physician | 208M00000X | 036103553 | IL |
Addresses
Primary practice location
2400 N Rockton Ave
Rockford, IL 61103-3655
Mailing address
2400 N Rockton Ave
Rockford, IL 61103-3655
Phone (815) 971-4025
Other practice location 1
8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-4066
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036103553 | Medicaid | IL |
Other names 1
- Rubina Naseer
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2400 N Rockton Ave
Rockford, IL 61103-3655
Phone (815) 971-3507
Hospital & facility affiliations
- Javon Bea Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036103553 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RMH Pathologists, LTD | Current | Accepting new patients | |
| Rockford Health Physicians | Current | Accepting new patients |
Locations
Carol Stream, IL 60122
29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652
2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310
8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066
2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510
Interoperability endpoints
- rehtesham48653@direct.mhemail.org
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Rockford, IL
- NPI 1043242886
-
- Anatomic Pathology Physician
- Rockford, IL
- NPI 1184671992
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Rockford, IL
- NPI 1629118609
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707177600000",
"number": "1962512152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 N ROCKTON AVE",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611033655",
"telephone_number": "815-971-4025",
"fax_number": "815-971-9299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 N ROCKTON AVE",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611033655",
"telephone_number": "815-971-4025"
}
],
"practiceLocations": [
{
"address_1": "8201 E Riverside Blvd",
"address_purpose": "LOCATION",
"city": "Rockford",
"state": "IL",
"postal_code": "611142300",
"country_code": "US",
"telephone_number": "815-971-4066",
"fax_number": "815-971-9299",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EHTESHAM",
"first_name": "RUBINA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2024-02-06",
"certification_date": "2024-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036103553",
"primary": true
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "IL",
"license": "036103553",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036103553",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "RUBINA",
"last_name": "NASEER",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.