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FOX RIDGE MEDICAL ASSOCIATES, LLC
NPI 1013402825
Internal Medicine in Mchenry, IL

Active since June 25, 2018CLIA 14D2150578 · Waiver
3633 MUNICIPAL DR, MCHENRY, IL 60050(815) 861-5543 Get Directions Write a Review

NPPES record last updated: August 28, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 28, 2018, Jun 25, 2018 (2 updates tracked since 2018).

About Fox Ridge Medical Associates, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FOX RIDGE MEDICAL ASSOCIATES, LLC (NPI 1013402825) is a healthcare organization registered as an internal medicine in Mchenry, Illinois and active in the NPI registry since June 2018. The organization holds a CLIA Waiver certificate valid through June 26, 2028 and lists Jeffrey Scott Tomlin, Practice Owner, as its authorized official.

NPPES Registry Identity

NPI1013402825
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameFOX RIDGE MEDICAL ASSOCIATES, LLC
Location Address3633 MUNICIPAL DRMchenry, IL 60050
Mailing Address3633 Municipal DrMchenry, IL 60050-5434 · (779) 244-3072 · Fax (815) 331-8389
Phone(815) 861-5543
Organization SubpartNo
Authorized OfficialJeffrey Scott TomlinPractice Owner · (815) 861-5543
Enumeration DateJune 25, 2018
Last NPPES UpdateAugust 28, 20182 updates tracked since enumeration
✔ NPI 1013402825 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 036.092485
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
3633 MUNICIPAL DR, Mchenry, IL 60050
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Other Identifiers 1

OtherF100494732Ptan

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fox Ridge Medical Associates, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Fox Ridge Medical Associates, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jeffrey Tomlin, M.D.
Internal Medicine
NPI 1639163850
3633 MUNICIPAL DR
Mchenry, IL 60050
(779) 244-3072
✔ PECOS✔ Accepts Medicare1.5 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2150578

Fox Ridge Medical Associates · Mchenry, IL
Active · expires Jun 26, 2028
CLIA Number14D2150578
Laboratory TypePhysician Office
Certificate Effective DateJune 27, 2026
Certificate Expiration DateJune 26, 2028
Laboratory DirectorJeffrey S. Tomlin
Laboratory Phone(779) 244-3072
Laboratory LocationFox Ridge Medical Associates3633 Municipal Dr, Mchenry, IL 60050
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fox Ridge Medical Associates, LLC's NPI number?

The NPI number for Fox Ridge Medical Associates, LLC is 1013402825. It was assigned to this organization in the NPPES registry on June 25, 2018.

Where is Fox Ridge Medical Associates, LLC located?

Fox Ridge Medical Associates, LLC is located at 3633 Municipal Dr, Mchenry, IL 60050. The listed phone number is (815) 861-5543.

What is Fox Ridge Medical Associates, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Fox Ridge Medical Associates, LLC enrolled in Medicare?

Yes. Fox Ridge Medical Associates, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Fox Ridge Medical Associates, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Fox Ridge Medical Associates, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Fox Ridge Medical Associates, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2150578) is associated with this NPI, valid through June 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Fox Ridge Medical Associates, LLC was last updated on August 28, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.