Individual provider Active NPI

Janet Ronquillo Barcarse

  • Medical Physician Assistant
  • Bolingbrook, IL
National Provider Identifier
1053935494
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
420 S. Schmidt Road
Suite 110
Bolingbrook, IL 60440-1737
Phone
(630) 312-4562
Fax
(630) 312-6651
NPI assigned
Jun 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Student in an Organized Health Care Education/Training Program 390200000X IL
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

420 S. Schmidt Road
Suite 110
Bolingbrook, IL 60440-1737

Mailing address

420 S. Schmidt Road
Suite 110
Bolingbrook, IL 60440-1737
Phone (630) 312-4562

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
I20211118002954 IL Practitioner - Physician Assistant 4981093598 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exhale Sinus PLLCGroup PAC ID 9133550635, 8 clinicians

Practice addresses (Care Compare)

814 E Woodfield Rd
Schaumburg, IL 60173-4714
Phone (773) 234-5880

National Provider Directory

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1053935494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 S. SCHMIDT ROAD",
            "address_2": "SUITE 110",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401737",
            "telephone_number": "630-312-4562",
            "fax_number": "630-312-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S. SCHMIDT ROAD",
            "address_2": "SUITE 110",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401737",
            "telephone_number": "630-312-4562",
            "fax_number": "630-312-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARCARSE",
        "first_name": "JANET",
        "middle_name": "RONQUILLO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-01",
        "last_updated": "2021-11-04",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.