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DR. RAJU M SHANMUGAM MD
NPI 1043448111
Family Medicine in Rockford, IL

Active since June 29, 2009PECOS EnrolledAccepts Medicare Assignment
3401 N PERRYVILLE RD, ROCKFORD, IL 61114(815) 971-2000(815) 971-2000 Get Directions Write a Review

NPPES record last updated: April 22, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 22, 2026, Feb 5, 2025, Aug 31, 2020 and 1 more (4 updates tracked since 2018).

About Dr. Raju M Shanmugam Md NPPES

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

DR. RAJU M SHANMUGAM MD (NPI 1043448111) is an individual family medicine provider in Rockford, Illinois, licensed in Illinois (036129587) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS, is affiliated with Uw Health, and is a graduate of Other (1999).

NPPES Registry Identity

NPI1043448111
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. RAJU M SHANMUGAMCredential: MD
Location Address3401 N PERRYVILLE RDRockford, IL 61114-8011
Mailing Address29624 Network PlChicago, IL 60673-1296 · (815) 971-2000 · Fax (815) 971-2000
Phone(815) 971-2000
Fax(815) 971-2000
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateJune 29, 2009
Last NPPES UpdateApril 22, 20264 updates tracked since enumeration
NPPES CertifiedApril 22, 2026
✔ NPI 1043448111 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 036129587
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedClinic/Center · Urgent CareTaxonomy 261QU0200X · License 036.129587 (IL)
3401 N PERRYVILLE RD, Rockford, IL 61114
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Other Identifiers 1

Medicaid1043448111WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include MercyCare Health Plans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Raju M Shanmugam Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1850543968
PECOS Enrollment IDI20121218000018
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
751 services397 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
225 services225 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
158 services54 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
119 services106 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
68 services65 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
43 services30 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Uw Health

Acute Care Hospitals · Rockford, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140228
Location1401 East State StreetRockford, IL 61104 · Winnebago County
Emergency services Birthing friendly

Saint Anthony Medical Center

Acute Care Hospitals · Rockford, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140233
Location5666 East State StreetRockford, IL 61108 · Winnebago County
Emergency services Birthing friendly

Javon Bea Hospital

Acute Care Hospitals · Rockford, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140239
Location8201 E Riverside BlvdRockford, IL 61114 · Winnebago County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61114 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
14 suppliers38 claims120 services$5.69 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
3 suppliers31 claims31 services$5.95 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
3 suppliers18 claims18 services$196.26 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TRACY LARKINS MUHAMMAD MD
Hospitalist
3401 N PERRYVILLE RD
ROCKFORD, IL 61114
Winnebago County (815) 971-2000
MICHELLE LEE CLEVELAND NP
Nurse Practitioner (Adult Health)
3401 N PERRYVILLE RD, SUITE 303
ROCKFORD, IL 61114
Winnebago County (815) 971-1060
LISA A ANGEL PT
Physical Therapist
3401 N PERRYVILLE RD, PHYSICAL THERAPY DEPT
ROCKFORD, IL 61114
Winnebago County (815) 971-2000
ADAM SOLIMAN MD
Otolaryngology
3401 N PERRYVILLE RD
ROCKFORD, IL 61114
Winnebago County (815) 971-2000
LUCY MARTIN
Nurse Practitioner
3401 N PERRYVILLE RD
ROCKFORD, IL 61114
Winnebago County (815) 971-2000
TRACY C BRITO M.D.
Phlebology
3401 N PERRYVILLE RD
ROCKFORD, IL 61114
Winnebago County (815) 971-2000
NICOLE M MOORE APN
Nurse Practitioner (Family)
3401 N PERRYVILLE RD
ROCKFORD, IL 61114
Winnebago County (815) 971-2000
PHILLIP A. HIGGINS MD
Obstetrics & Gynecology
3401 N PERRYVILLE RD
ROCKFORD, IL 61114
Winnebago County (815) 971-2000

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 Raju Shanmugam's NPI number?

The NPI number for Raju Shanmugam is 1043448111. It was assigned to this individual provider in the NPPES registry on June 29, 2009.

Where is Raju Shanmugam located?

Raju Shanmugam practices at 3401 N Perryville Rd, Rockford, IL 61114. The listed phone number is (815) 971-2000.

What is Raju Shanmugam's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Raju Shanmugam enrolled in Medicare?

Yes. Raju Shanmugam is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Raju Shanmugam accept?

Health plans from MercyCare Health Plans list Raju Shanmugam as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Raju Shanmugam affiliated with any hospitals?

According to CMS data, Raju Shanmugam is affiliated with Uw Health, Saint Anthony Medical Center and Javon Bea Hospital.

When was this NPI record last updated?

The NPPES record for Raju Shanmugam was last updated on April 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.