Individual provider Active NPI

Elizabeth Jarrin, N.P.

  • Gerontology Nurse Practitioner
  • Elgin, IL
National Provider Identifier
1164845152
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
209010879 Issued in IL
Practice address
1530 N Randall Rd Ste 210
Elgin, IL 60123-7879
Phone
(224) 760-7322
Fax
(224) 525-8252
NPI assigned
Jan 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 209010879 IL Primary

Addresses

Primary practice location

1530 N Randall Rd Ste 210
Elgin, IL 60123-7879

Mailing address

6400 Industrial Loop
Greendale, WI 53129-2452
Phone (414) 858-4106

Other practice location 1

1990 Larkin Ave
Suite 3
Elgin, IL 60123
Phone (847) 289-5727

Other names 1

  • Elizabeth Puga Former name

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
I20140304000409 IL Practitioner - Nurse Practitioner 5193785749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chestnut Health of Illinois LLCGroup PAC ID 2264747344, 38 clinicians

Practice addresses (Care Compare)

50 N Jane Dr
Elgin, IL 60123-5118
Phone (847) 697-3750

Merit-based Incentive Payment System (MIPS)

Final score
20.52 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
68.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chestnut Health of Illinois LLC CurrentSince Apr 1, 2018 Accepting new patients
William F. Puga, M.D. and Associates, S.C. PastSince Mar 11, 2003 Accepting new patients

Locations

50 N Jane Dr
Elgin, IL 60123
Phone (815) 844-2610

77 N Airlite St
Elgin, IL 60123
Phone (847) 622-3407

1530 N Randall Rd
Ste 210
Elgin, IL 60123
Phone (224) 760-7322

612 W Saint Marys Rd
Sterling, IL 61081
Phone (815) 626-9020

6400 Industrial Loop
Greendale, WI 53129
Phone (414) 423-4100

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.

NPI Registry JSON

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

{
    "created_epoch": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1164845152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-858-4106",
            "fax_number": "414-423-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 N RANDALL RD STE 210",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601237879",
            "telephone_number": "224-760-7322",
            "fax_number": "224-525-8252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1990 Larkin Ave",
            "address_2": "Suite 3",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "60123",
            "country_code": "US",
            "telephone_number": "847-289-5727",
            "fax_number": "847-888-5469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JARRIN",
        "first_name": "ELIZABETH",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-27",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209010879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "PUGA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.