DR. FOWZIA S GHOUSE MD
NPI 1215923826
Family Medicine in Naperville, IL

Q: What is Fowzia Ghouse's NPI number?

The NPI number for Fowzia Ghouse is 1215923826. It was assigned to this individual provider in the NPPES registry on September 20, 2005.

Q: What is Fowzia Ghouse's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Fowzia Ghouse was last updated on December 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since September 20, 2005PECOS EnrolledAccepts Medicare Assignment

91.35/100

CMS Quality Rating

1331 W 75TH ST STE 202, NAPERVILLE, IL 60540(630) 922-1400(630) 904-7378 Get Directions Write a Review

NPPES record last updated: December 16, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Dr. Fowzia S Ghouse Md NPPES

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

DR. FOWZIA S GHOUSE MD (NPI 1215923826) is an individual family medicine provider in Naperville, Illinois, licensed in Illinois (036096076) and active in the NPI registry since September 2005. She is enrolled in Medicare PECOS, is affiliated with Swedish Hospital, and is a graduate of Rush Medical College Of Rush University (1995).

NPPES Registry Identity

NPI1215923826

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. FOWZIA S GHOUSECredential: MD

Location Address1331 W 75TH ST STE 202Naperville, IL 60540-9311

Mailing Address1331 W 75th St Ste 202Naperville, IL 60540-9311 · (630) 922-1400 · Fax (630) 904-7378

Phone(630) 922-1400

Fax(630) 904-7378

Sole ProprietorYes

Medical School CMSRush Medical College Of Rush UniversityGraduated 1995

Enumeration DateSeptember 20, 2005

Last NPPES UpdateDecember 16, 2020

NPPES CertifiedDecember 16, 2020

✔ NPI 1215923826 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in IL · 036096076

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.

1331 W 75TH ST STE 202, Naperville, IL 60540

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Other Identifiers 1

Medicaid036096076IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Fowzia S Ghouse 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 ID9436118452

PECOS Enrollment IDI20100913001071

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.

Medicare Billing Reassignments

Medicare enrollment records show Fowzia Ghouse reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Edward Health Ventures

0.5 mi

Family Medicine

1828 BAY SCOTT CIR, STE 112
Naperville, IL 60540

Reassigned Medicare billing, Illinois enrollment
561 clinicians in this Medicare group

NPI 1699193003 (630) 420-1500

Endeavor Health Medical Group

33 mi

Allergy & Immunology

1000 CENTRAL ST
Evanston, IL 60201

Reassigned Medicare billing, Illinois enrollment
4,841 clinicians in this Medicare group

NPI 1497701882 (847) 570-5235

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

Areas of Expertise CMS Part B claims 7

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.

149 services59 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.

46 services46 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

38 services28 patients

Blood glucose (sugar) level 82947

A blood glucose level test measures the amount of sugar in your blood. It's often used to monitor and manage conditions like diabetes. High or low levels can indicate a health issue. The test is usually done by pricking your finger for a small blood sample.

29 services14 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.

24 services21 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

18 services18 patients

Hospital Affiliations CMS Care Compare 2

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

Swedish Hospital

Acute Care Hospitals · Chicago, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140114

Location5145 N California AveChicago, IL 60625 · Cook County

Emergency services Birthing friendly

Edward Hospital

Acute Care Hospitals · Naperville, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140231

Location801 South WashingtonNaperville, IL 60540 · Du Page County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60540 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

$93.02 typical visit price

range $59.81 – $181.38

Typical copayment $23.25 (range $14.95 – $45.34)

Most-billed visit code 99203

Established Patient

$105.07 typical visit price

range $19.15 – $147.12

Typical copayment $26.26 (range $4.78 – $36.78)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

91.35/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

82.71

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims

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

10 suppliers24 claims54 services$4.70 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 7

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

DR. MADHAVI MANUBOLU MD

Family Medicine