Individual provider Active NPI

Mayson Lyn Marcy, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1134828221
Registry record updated Oct 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085011338 Issued in IL
Practice address
2418 N Ashland Ave
Chicago, IL 60614-2021
Phone
(773) 900-8330
Fax
(312) 761-1855
NPI assigned
Feb 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2025

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 085011338 IL Primary

Addresses

Primary practice location

2418 N Ashland Ave
Chicago, IL 60614-2021

Mailing address

868 N Wells St Apt 903
Chicago, IL 60610-3675
Phone (615) 440-1283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230726002755 TN Practitioner - Physician Assistant 9133580954 Reassigns benefits to 1 organization
I20250905001191 IL Practitioner - Physician Assistant 9133580954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2400 N Ashland
Chicago, IL 60614

2418 N Ashland
Chicago, IL 60614

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Merit-based Incentive Payment System (MIPS)

Final score
85.88 of 100Reported as group
Quality
71.04
Promoting interoperability
100
Improvement activities
40
Cost
81.88

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Medspa PLLC CurrentSince Oct 5, 2025 Accepting new patients

Locations

2418 N Ashland Ave
Chicago, IL 60614
Phone (773) 270-5600

Interoperability endpoints

  • Direct secure messaging: mayson.marcy.1@13676.direct.athenahealth.com
  • Direct secure messaging: mayson.marcy@krogerhealth.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1134828221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "868 N WELLS ST APT 903",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606103675",
            "telephone_number": "615-440-1283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606142021",
            "telephone_number": "773-900-8330",
            "fax_number": "312-761-1855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCY",
        "first_name": "MAYSON",
        "middle_name": "LYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085011338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.