Individual provider Active NPI

Kelly Pjevcevic, PA-C

  • Physician Assistant
  • Morton Grove, IL
National Provider Identifier
1013197110
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-003156 Issued in IL
Practice address
9000 Waukegan Rd
Suite 200
Morton Grove, IL 60053-2127
Phone
(847) 324-3976
NPI assigned
Nov 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-003156 IL Primary

Addresses

Primary practice location

9000 Waukegan Rd
Suite 200
Morton Grove, IL 60053-2127

Mailing address

900 Rand Rd Ste 300
Attn: Raquel Leon
Des Plaines, IL 60016-2359
Phone (847) 324-3976

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080506000526 IL Practitioner - Physician Assistant 2860571510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Bone and Joint Institute, LLCGroup PAC ID 6002814878, 603 clinicians

Practice addresses (Care Compare)

1775 Dempster St
Park Ridge, IL 60068-1143
Phone (847) 723-5099

2101 Waukegan Rd
Bannockburn, IL 60015-1836

9000 Waukegan Rd
Morton Grove, IL 60053-2127
Phone (847) 213-5444

Hospital & facility affiliations

  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223

Merit-based Incentive Payment System (MIPS)

Final score
81.07 of 100Reported as group
Quality
76.54
Promoting interoperability
83
Improvement activities
40
Cost
74.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-003156ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Bone and Joint Institute LLC CurrentSince Nov 26, 2007 Accepting new patients
Illinois Bone and Joint Institute, LLC CurrentSince Nov 26, 2007 Accepting new patients

Locations

2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096

1450 Busch Pkwy
Ste 115
Buffalo Grove, IL 60089
Phone (224) 676-7920

5057 Paysphere Cir
Chicago, IL 60674

900 Rand Rd
Ste 200
Des Plaines, IL 60016
Phone (847) 324-3978

900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090

716 Florsheim Dr
Libertyville, IL 60048
Phone (847) 918-9077

9000 Waukegan Rd
Ste 200
Morton Grove, IL 60053

Interoperability endpoints

  • Direct secure messaging: kpjevcevic251183@direct.myadvocateaurora.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1013197110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RAND RD STE 300",
            "address_2": "ATTN: RAQUEL LEON",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162359",
            "telephone_number": "847-324-3976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 WAUKEGAN RD",
            "address_2": "SUITE 200",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532127",
            "telephone_number": "847-324-3976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PJEVCEVIC",
        "first_name": "KELLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-06",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-003156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton Grove, IL

Sources for this page

Verify at the official NPI Registry.