| Moses Godofredo Tomacruz, MD | |
|
1502 Parkview Ave, Rockford, IL 61107-1821 | |
| (815) 381-7250 | |
| (815) 381-7251 |
| Full Name | Moses Godofredo Tomacruz |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 23 Years |
| Location | 1502 Parkview Ave, Rockford, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144414921 | NPI | - | NPPES |
| 36120622 | Medicaid | IL | |
| 553180 | Other | IL | MEDICARE GROUP # |
| 801570 | Other | IL | MEDICARE GROUP # |
| 834370 | Other | IL | MEDICARE GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036-120622 (Illinois) | Primary |
| 207Q00000X | Family Medicine | MT186770 (Pennsylvania) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Residential Home Health | Downers grove, IL | Home health agency |
| Edward Hospital | Naperville, IL | Hospital |
| Swedish Covenant Hospital | Chicago, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Endeavor Health Medical Group | 2163334699 | 3022 |
| Entity Name | Edward Health Ventures |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962452912 PECOS PAC ID: 4284531484 Enrollment ID: O20031216000616 |
| Entity Name | Endeavor Health Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1497701882 PECOS PAC ID: 2163334699 Enrollment ID: O20040524000118 |
| Mailing Address | Practice Location Address |
|---|---|
| Moses Godofredo Tomacruz, MD 24600 W 127th St Ste 100, Plainfield, IL 60585-9507 Ph: (815) 731-9000 | Moses Godofredo Tomacruz, MD 1502 Parkview Ave, Rockford, IL 61107-1821 Ph: (815) 381-7250 |
Srivani Sridhar, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3505 N. Bell School Rd., Rockford, IL 61114 Phone: 779-696-0300 | |
Dr. John Wall, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1200 W State St, Rockford, IL 61102 Phone: 815-490-1600 | |
Dr. Steven J Lidvall, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1215 N Alpine Rd, Rockford, IL 61107 Phone: 815-391-7807 | |
Dr. Arpana Broor Mathur, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 698 Featherstone Rd, Suite 250, Rockford, IL 61107 Phone: 815-399-4404 Fax: 815-484-7091 | |
Ms. Rachael Mcpeek, NP Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1215 N Alpine Rd, Rockford, IL 61107 Phone: 815-490-1600 | |
Dr. Jithinraj Edakkanambeth Varayil, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1200 W State St, Rockford, IL 61102 Phone: 815-490-1600 Fax: 815-490-1881 | |
Dr. Raju M Shanmugam, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3401 N Perryville Rd, Rockford, IL 61114 Phone: 815-971-2000 Fax: 815-971-2000 |