Ellissa A Schwartz, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085-002771 Issued in IL

Practice address

6830 Villagreen VW
Rockford, IL 61107-5639

Phone

(815) 282-1339

Fax

(815) 282-1298

NPI assigned

May 7, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Ellissa A Mette Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1003029224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6830 VILLAGREEN VIEW",
            "address_2": "OSF MEDICAL GROUP-SPRINGCREEK",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075639",
            "telephone_number": "815-282-1339",
            "fax_number": "815-282-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6830 VILLAGREEN VW",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075639",
            "telephone_number": "815-282-1339",
            "fax_number": "815-282-1298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "ELLISSA",
        "middle_name": "A",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-002771",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA #052890",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2370-023",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "553180",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "834340",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "846930",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLISSA",
            "last_name": "METTE",
            "middle_name": "A",
            "credential": "PHYSICIAN ASSISTANT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Taresa Jo Schuster, LCSW
• Matthew David Schwabero, PA-C
• Mary Colette Schwamberger, M.S., CCC-SLP
• Edric G Schwartz, MD
• Elizabeth C Schwartz, SLP
• Julie Ann Schwebke
• Karyn Barbara Schwitters, LCSW
• Salvatore A Sciortino, D.D.S.
• Corrie Elizabeth Scott, APN
• Jennifer Anne Scott, MS CCC SLP L

• Physician Assistant in Rockford, IL
• Providers in Rockford, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.