Individual provider Active NPI

Amela I Dedic, PA-C

  • Physician Assistant
  • Bloomingdale, IL
National Provider Identifier
1154198133
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
245 S Gary Ave
Bloomingdale, IL 60108-2228
Phone
(630) 893-5230
NPI assigned
Dec 8, 2023
Last updated
Oct 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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 NU Primary

Addresses

Primary practice location

245 S Gary Ave
Bloomingdale, IL 60108-2228

Mailing address

435 N 5TH St
Phoenix, AZ 85004-2157

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
I20241231000573 IL Practitioner - Physician Assistant 4981131000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
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)

245 S Gary Ave
Suite 200
Bloomingdale, IL 60108-2218
Phone (630) 893-5230

245 S Gary Ave LL
Martin T Russo
Bloomingdale, IL 60108-2228
Phone (630) 893-5230

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Network CurrentSince Jan 13, 2025 Accepting new patients
Access Community Health Network CurrentSince Jan 13, 2025 Accepting new patients

Locations

245 S Gary Ave
Bloomingdale, IL 60108
Phone (630) 305-6301

245 S Gary Ave
Ste 200
Bloomingdale, IL 60108
Phone (630) 893-5230

600 W Fulton St
Ste 300
Chicago, IL 60661

Interoperability endpoints

  • Direct secure messaging: adedic26924@direct.achn.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1154198133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 N 5TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850042157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 S GARY AVE",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082228",
            "telephone_number": "630-893-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDIC",
        "first_name": "AMELA",
        "middle_name": "I",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-08",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

Verify at the official NPI Registry.