Individual provider Active NPI

Olivia Kathryn Mason, PA-C

  • Surgical Physician Assistant
  • Highland Park, IL
National Provider Identifier
1063351609
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085012286 Issued in IL
Practice address
777 Park Ave W
Highland Park, IL 60035-2433
Phone
(847) 432-9000
NPI assigned
Mar 27, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X IL
Surgical Physician Assistant 363AS0400X 085012286 IL Primary

Addresses

Primary practice location

777 Park Ave W
Highland Park, IL 60035-2433

Mailing address

2650 Ridge Ave
Evanston, IL 60201-1700

Other practice location 1

283 Cherry Ln
Kennett Square, PA 19348-4708
Phone (484) 844-1287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
R Franklin University of Med & Sci/Chicago Medical School, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2650 Ridge Ave
Suite 1223
Evanston, IL 60201-1700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1774569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1063351609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 PARK AVE W",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352433",
            "telephone_number": "847-432-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "283 Cherry Ln",
            "address_purpose": "LOCATION",
            "city": "Kennett Square",
            "state": "PA",
            "postal_code": "193484708",
            "country_code": "US",
            "telephone_number": "484-844-1287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASON",
        "first_name": "OLIVIA",
        "middle_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-27",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085012286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

Verify at the official NPI Registry.