Individual provider Active NPI

Mireya Ledesma, PA-C

  • Physician Assistant
  • Buffalo Grove, IL
National Provider Identifier
1063530368
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
600 W Lake Cook Rd Ste 120
Buffalo Grove, IL 60089-2085
Phone
(847) 808-8884
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 IL Primary

Addresses

Primary practice location

600 W Lake Cook Rd Ste 120
Buffalo Grove, IL 60089-2085

Mailing address

45 Amber CT Unit Z2
Schaumburg, IL 60193-5765
Phone (847) 798-8376

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
I20110214000606 IL Practitioner - Physician Assistant 2466632096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Community Health NetworkGroup PAC ID 9537076112, 182 clinicians

Practice addresses (Care Compare)

1120 N Arlington Heights Rd
Arlington Heights, IL 60004-4767
Phone (847) 342-1554

7450 W 63Rd St
Des Plaines Valley Family Health Center
Summit, IL 60501-1816
Phone (708) 458-0757

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Network CurrentSince Sep 5, 2017 Accepting new patients
Access Community Health Network CurrentSince Sep 5, 2017 Accepting new patients
Access Community Health Network Past Accepting new patients

Locations

1120 N Arlington Heights Rd
Arlington Heights, IL 60004
Phone (847) 342-1554

600 W Fulton St
Ste 200
Chicago, IL 60661
Phone (312) 526-2000

Interoperability endpoints

  • Direct secure messaging: mledesma5782@direct.achn.net

Organizations & group practices 4

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1063530368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 AMBER CT UNIT Z2",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601935765",
            "telephone_number": "847-798-8376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W LAKE COOK RD STE 120",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600892085",
            "telephone_number": "847-808-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDESMA",
        "first_name": "MIREYA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo Grove, IL

Sources for this page

Verify at the official NPI Registry.