DR. MOHANNAD RAJJOUB (MD) – Obstetrics & Gynecology Physician, NPI 1255659587
Obstetrics & Gynecology Physician
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Profile Insights
NPPES metrics only — not quality of care.
962 OBSTETRICS/GYNECOLOGY in IN
Provider Addresses for DR. MOHANNAD RAJJOUB (MD)
1205 HADLEY RD STE 120
MOORESVILLE, IN 461581934
Phone: (317) 834-8950
Fax: (317) 834-8951
Type: Location
707 N LOGAN AVE
DANVILLE POLYCLINIC, LTD.
DANVILLE, IL 618324360
Phone: (217) 477-4719
Fax: (217) 477-4758
Type: Mailing
200 E Fairman Ave
Watseka, IL 609701644
Phone: (815) 432-5841
Type: Location
707 N Logan Ave
DANVILLE POLYCLINIC, LTD.
Danville, IL 618324360
Phone: (217) 477-4719
Fax: (217) 477-4758
Type: Location
PO BOX 781076
DETROIT, MI 482781008
Phone: (317) 528-4800
Fax: (317) 865-1479
Type: Mailing
200 E FAIRMAN AVE
WATSEKA, IL 609701644
Phone: (815) 432-7775
Fax: (815) 432-7722
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $155.
Total Amount is formed as General ($155) + Research ($0) + Ownership ($0) = $155.
Last reported payment date: 2023-11-10 • Largest payer in this snapshot: Astellas Pharma US Inc ($42).
Total Amount
$155
General + Research + Ownership
Payments
8
Total payment records
General Amount
$155
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Astellas Pharma US Inc | $42 |
| Organon LLC | $34 |
| Sumitomo Pharma America, Inc. | $24 |
| Axsome Therapeutics, Inc. | $22 |
| Agile Therapeutics, Inc. | $17 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-12-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20120808000934 | I | Obstetrics/Gynecology | IL | TBD |
| I20251210000535 | I | Obstetrics/Gynecology | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 46158)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| OBSTETRICS/GYNECOLOGY | IL | 76830 | Ultrasound pelvis through vagina | 21 | 18 |
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