Individual provider Active NPI

Amy Brussee, MS PA

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1033340153
Registry record updated Aug 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085003499 Issued in IL
Practice address
111 W Washington St
Suite 903
Chicago, IL 60602-2703
Phone
(312) 372-9355
Fax
(312) 372-9356
NPI assigned
Aug 6, 2009
Last updated
Aug 6, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2009

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 085003499 IL Primary

Addresses

Primary practice location

111 W Washington St
Suite 903
Chicago, IL 60602-2703

Mailing address

PO Box 160
Matteson, IL 60443-0160
Phone (708) 747-5850

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
I20091202000546 IL Practitioner - Physician Assistant 1557400629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chicago Nasal and Sinus Center S CGroup PAC ID 1254333867, 3 clinicians

Practice addresses (Care Compare)

111 W Washington St
Suite 903
Chicago, IL 60602-2762
Phone (312) 372-9355

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085003499ILMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: abrussee@cnsc.directglo.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249516800000",
    "number": "1033340153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604430160",
            "telephone_number": "708-747-5850",
            "fax_number": "708-747-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W WASHINGTON ST",
            "address_2": "SUITE 903",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606022703",
            "telephone_number": "312-372-9355",
            "fax_number": "312-372-9356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUSSEE",
        "first_name": "AMY",
        "credential": "MS  PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-06",
        "last_updated": "2009-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.