Kaitlin Cavanagh, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

085.008261 Issued in IL

Practice address

880 W Central Rd Ste 5000
Arlington Heights, IL 60005-2355

Phone

(847) 618-3800

Fax

(847) 618-3809

NPI assigned

Apr 23, 2020

Last updated

Oct 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oak Dermatology LLCGroup PAC ID 7810256849, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Oak Dermatology LLC

  • MOHS-Micrographic Surgery Physician
  • Itasca, IL
  • NPI 1487168258
  Medicare reassignment Care Compare group
• Rush University Medical Group

  dba Rush University Internists

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542
  NPD (past)

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1144840703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 W CENTRAL RD STE 5000",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052355",
            "telephone_number": "847-618-3800",
            "fax_number": "847-618-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 W CENTRAL RD STE 5000",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052355",
            "telephone_number": "847-618-3800",
            "fax_number": "847-618-3809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAGH",
        "first_name": "KAITLIN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-23",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085.008261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "085.008261",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcavanagh145869@direct.nch.org",
            "affiliation": "N",
            "address_1": "880 W Central Rd Ste 5000",
            "city": "Arlington Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600052355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine Jean Cassara
• Meribeth Marie Cassidy, MS OTR/L
• Adele Anna Castaldi, DO
• Bart Castillo, ATC
• Kelli Marie Castro, APRN, AGACNP-BC
• John William Cavers, DDS
• Alfredo Ceballos Jr., M.D.
• Claire Cebrij, LCSW
• Samuel Celske
• Center for Emotional Wellness & Personal Development

• Surgical Physician Assistant in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Surgical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.