Mary Catherine (Katie) Rybak, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036128107 Issued in IL

Practice address

4550 Memorial Dr
Ste. 340
Belleville, IL 62226-5372

Phone

(618) 257-6200

Fax

(618) 257-6679

NPI assigned

Jul 8, 2008

Sex

Female

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

Electronic endpoints 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cep America - Illinois SNF, LLP

  • Internal Medicine Physician
  • Belleville, IL
  • NPI 1073069415

  IL, Internal Medicine

  Medicare reassignment NPD
• Cep America-Illinois Hospitalists, LLP

  • Internal Medicine Physician
  • Belleville, IL
  • NPI 1841613403

  IL, Internal Medicine

  Medicare reassignment NPD
• Cep America - Illinois Hospitalists, LLP

  • Internal Medicine Physician
  • Alton, IL
  • NPI 1164973947

  Internal Medicine

  NPD
• Cep America - Illinois SNF LLP

  • Internal Medicine Physician
  • Edwardsville, IL
  • NPI 1043170434

  Internal Medicine

  NPD
• Cep America - Illinois SNF, LLP

  • Internal Medicine Physician
  • Belleville, IL
  • NPI 1225552920

  Internal Medicine

  NPD
• Cep America-Illinois Hospitalists

  • Hospitalist Physician
  • Bloomington, IL
  • NPI 1669276523

  Hospitalist

  NPD
• PC Associates LLC

  • Internal Medicine Physician
  • O'Fallon, IL
  • NPI 1235452855

  Internal Medicine

  NPD (past)
• Fairview Heights Medical Group SC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1679503668
  NPD (past)

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1962665059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 MEMORIAL DR",
            "address_2": "STE. 340",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265372",
            "telephone_number": "618-257-6200",
            "fax_number": "618-257-6679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 MEMORIAL DR",
            "address_2": "STE. 340",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265372",
            "telephone_number": "618-257-6200",
            "fax_number": "618-257-6679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1414 Cross St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Shiloh",
            "state": "IL",
            "postal_code": "622692988",
            "country_code": "US",
            "telephone_number": "618-607-1260",
            "fax_number": "618-624-4865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYBAK",
        "first_name": "MARY",
        "middle_name": "CATHERINE (KATIE)",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-08",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036128107",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036128107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDFPR",
            "identifier": "036128107",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1414 Cross St Ste 210",
            "city": "Shiloh",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622692988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lito T Rufin, NP
• Beth E Rule, LPT
• Adam Thomas Ruley, M.D.
• Kimberly Ann Rurack, LCPC
• Natalie D Ruth
• Kimberly Joanna Sachs, D.C.
• Sacral Function Therapy, PLLC
• Kahmalia-Kalee Conceptia Sada, MD
• Sheikh M Sadiq, MD
• Sarah Christine Saettele

• All providers in Belleville, IL
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.