Amaya Briann Blue-Farrell

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.010526 Issued in IL

Practice address

4025 N Sheridan Rd
Chicago, IL 60613-2010

Phone

(773) 388-1600

NPI assigned

Jun 2, 2022

Last updated

Aug 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Northwestern University Feinberg Medical School, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Howard Brown Health CenterGroup PAC ID 1052203155, 52 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Howard Brown Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1306048632
  Medicare reassignment Care Compare group NPD (past)
• Howard Brown Health Center

  dba Howard Brown Health at TPAN

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1356876387
  NPD
• Howard Brown Health Center

  dba Howard Brown Health at La Casa Norte

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1427523125
  NPD
• Howard Brown Health Center

  • Health Educator
  • Chicago, IL
  • NPI 1811824121
  NPD (past)

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1053050542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132010",
            "telephone_number": "773-388-1600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 E Huron St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112909",
            "country_code": "US",
            "telephone_number": "312-503-1851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLUE-FARRELL",
        "first_name": "AMAYA",
        "middle_name": "BRIANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-02",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.010526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Ribbon Taxi Association Inc.
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• Blueapple Health
• Bluebird Wellness. LLC
• Bluehealth Medical LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.