Individual provider Active NPI

Kathleen Lacci Bienia, PA-C, MMSC

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1144545237
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085003678 Issued in IL
Practice address
2545 S King Dr
Sykes Advocate Medical Group
Chicago, IL 60616-2441
Phone
(312) 842-7117
Fax
(312) 808-3383
NPI assigned
Mar 31, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085-003678 IL
Physician Assistant 363A00000X 085003678 IL Primary

Addresses

Primary practice location

2545 S King Dr
Sykes Advocate Medical Group
Chicago, IL 60616-2441

Mailing address

2545 S King Dr
Sykes Advocate Medical Group
Chicago, IL 60616-2441
Phone (312) 842-7117

Other identifiers 1

IdentifierTypeStateIssuer
085-003678OtherILSTATE LICENSE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kbienia205133@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20131118001188 IL Practitioner - Physician Assistant 6305085465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085-003678ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Sep 30, 2013 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Sep 30, 2013 Accepting new patients

Locations

595 William R Latham SR Dr
Bourbonnais, IL 60914
Phone (815) 932-8944

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

135 N Arlington Heights Rd
Buffalo Grove, IL 60089
Phone (847) 215-8866

2545 S Ml King Dr
Chicago, IL 60616
Phone (312) 842-7117

29373 Network Pl
Chicago, IL 60673

2535 S King Dr
Chicago, IL 60616
Phone (312) 842-7117

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.

Hospital & facility affiliations 4

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": "1269993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1144545237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 S KING DR",
            "address_2": "SYKES ADVOCATE MEDICAL GROUP",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162441",
            "telephone_number": "312-842-7117",
            "fax_number": "312-808-3383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 S KING DR",
            "address_2": "SYKES ADVOCATE MEDICAL GROUP",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162441",
            "telephone_number": "312-842-7117",
            "fax_number": "312-808-3383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIENIA",
        "first_name": "KATHLEEN",
        "middle_name": "LACCI",
        "name_prefix": "Mrs.",
        "credential": "PA-C, MMSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-31",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085-003678",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "085-003678",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbienia205133@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2545 S King Dr",
            "address_2": "Sykes Advocate Medical Group",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606162441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2545 S King Dr",
            "address_2": "Sykes Advocate Medical Group",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606162441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.