Carrie L Kopala, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085002659 Issued in IL

Practice address

1850 Gateway Dr
Sycamore, IL 60178-3192

Phone

(815) 766-9901

Fax

(815) 758-7298

NPI assigned

Mar 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine Kishwaukee Hospital Hospital, Dekalb, IL, CCN 140286
• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21874/brand/1/csg/1/fhir/r4

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.

• Central Dupage Physician Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844
  Medicare reassignment Care Compare group
• Elio M Vento MD & Associates SC

  • Internal Medicine Physician
  • Elgin, IL
  • NPI 1063635431
  Medicare reassignment
• Central Dupage Physician Group

  • Orthopaedic Surgery Physician
  • Geneva, IL
  • NPI 1780012344
  NPD
• Advanced Renal Care LTD

  • Nephrology Physician
  • Lombard, IL
  • NPI 1740307743
  NPD (past)
• Adventist Health Partners, Inc

  • Family Medicine Physician
  • Hinsdale, IL
  • NPI 1952339939
  NPD (past)
• Adventist Health Partners,Inc

  • Family Medicine Physician
  • Bloomingdale, IL
  • NPI 1043255888
  NPD (past)
• Cardinalight Health, LLC

  • Family Nurse Practitioner
  • Crystal Lake, IL
  • NPI 1760956726
  NPD (past)

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

• Central Dupage Hospital Association

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation
• Kishwaukee Community Hospital

  • General Acute Care Hospital
  • Dekalb, IL
  • NPI 1669534517
  Care Compare affiliation

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1053371849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 GATEWAY DR",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783192",
            "telephone_number": "815-766-9901",
            "fax_number": "815-758-7298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 GATEWAY DR",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783192",
            "telephone_number": "815-766-9901",
            "fax_number": "815-758-7298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Kish Hospital Dr Ste 104",
            "address_purpose": "LOCATION",
            "city": "Dekalb",
            "state": "IL",
            "postal_code": "601159602",
            "country_code": "US",
            "telephone_number": "815-766-9901",
            "fax_number": "815-758-7298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOPALA",
        "first_name": "CARRIE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda L Koach
• James Kolar, M.D.
• Denny Kolkebeck, DPT
• Christine Konecny
• Steven Anthony Koos, MD DDS
• Vera Kotelnikova
• Brianna Kraft, ATC
• Matthew Kraft, ATC
• Tara Kristiansen, APRN
• Bryan M Kruskol, DO

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.