Individual provider Active NPI

Anthony Edward Falcon, PA-C

  • Physician Assistant
  • Blue Island, IL
National Provider Identifier
1063922854
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085006340 Issued in IL
Practice address
12935 Gregory St
Blue Island, IL 60406-2428
Phone
(708) 597-2000
NPI assigned
Oct 5, 2017
Last updated
Jun 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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 085006340 IL Primary

Addresses

Primary practice location

12935 Gregory St
Blue Island, IL 60406-2428

Mailing address

4721 N Malden St Unit GN
Chicago, IL 60640-7180
Phone (917) 604-3605

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
I20171129000794 IL Practitioner - Physician Assistant 0244597201 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Insight Chicago IncGroup PAC ID 2860894706, 140 clinicians

Practice addresses (Care Compare)

2525 S Michigan Ave
Chicago, IL 60616-2315
Phone (708) 382-1498

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Illinois, P.C. CurrentSince Mar 1, 2020 Accepting new patients
Cep America - Illinois, LLP CurrentSince Aug 1, 2020 Accepting new patients
Inpatient Consultants of Illinois, P.C. CurrentSince Mar 1, 2020 Accepting new patients
Cepamerica Illinois LLP CurrentSince Aug 1, 2020 Accepting new patients
Insight Chicago, Inc. CurrentSince Jun 1, 2021 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150

1325 N Highland Ave
Aurora, IL 60506
Phone (630) 801-2756

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

2525 S Michigan Ave
Chicago, IL 60616
Phone (312) 355-1153

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

1555 N Barrington Rd
Hoffman Estates, IL 60169
Phone (847) 490-2923

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1507161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1063922854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4721 N MALDEN ST UNIT GN",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407180",
            "telephone_number": "917-604-3605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12935 GREGORY ST",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062428",
            "telephone_number": "708-597-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALCON",
        "first_name": "ANTHONY",
        "middle_name": "EDWARD",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-05",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Island, IL

Sources for this page

Verify at the official NPI Registry.