Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

NOLAN JACOB INTERIAL DO
NPI 1093343964
Internal Medicine - Nephrology in Rockford, IL

Q: What is Nolan Interial's NPI number?

The NPI number for Nolan Interial is 1093343964. It was assigned to this individual provider in the NPPES registry on March 27, 2020.

Q: What is Nolan Interial's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: When was this NPI record last updated?

The NPPES record for Nolan Interial was last updated on August 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 24 days 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.

Active since March 27, 2020PECOS Enrolled

612 ROXBURY RD, ROCKFORD, IL 61107(815) 227-8300 Get Directions Write a Review

NPPES record last updated: August 17, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Aug 17, 2026, Jul 9, 2026, Jun 12, 2025 and 4 more (7 updates tracked since 2020).

On this page

About Nolan Jacob Interial Do NPPES

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

NOLAN JACOB INTERIAL DO (NPI 1093343964) is an individual nephrology provider in Rockford, Illinois, licensed in Wisconsin (81106-21) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS, is affiliated with Unitypoint Health - Meriter, and is a graduate of Lincoln Mem Univ, Debusk Col Of Osteopathic Med (2020).

NPPES Registry Identity

NPI1093343964

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameNOLAN JACOB INTERIALCredential: DO

Location Address612 ROXBURY RDRockford, IL 61107-5089

Mailing Address612 Roxbury RdRockford, IL 61107-5089

Phone(815) 227-8300

Sole ProprietorNo

Medical School CMSLincoln Mem Univ, Debusk Col Of Osteopathic MedGraduated 2020

Enumeration DateMarch 27, 2020

Last NPPES UpdateAugust 17, 20267 updates tracked since enumeration

NPPES CertifiedAugust 17, 2026

✔ NPI 1093343964 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in WI · 81106-21

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

612 ROXBURY RD, Rockford, IL 61107

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Nolan Jacob Interial Do 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 ID1254738263

PECOS Enrollment IDI20250912000719

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.

Hospital Affiliations CMS Care Compare 2

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

Unitypoint Health - Meriter

Acute Care Hospitals · Madison, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520089

Location202 S Park StMadison, WI 53715 · Dane County

Emergency services Birthing friendly

University Of Wi Hospitals & Clinics Authority

Acute Care Hospitals · Madison, WI

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number520098

Location600 Highland AvenueMadison, WI 53792 · Dane County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61107 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

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

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.

Other Providers at the Same Location NPPES 18

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

NEPHROLOGY ASSOCIATES OF NORTHERN ILLINOIS LTD

Internal Medicine (Nephrology)