Individual provider Active NPI

Kimberly Lynn Swarbrick, PA-C

  • Physician Assistant
  • Wauconda, IL
National Provider Identifier
1174832257
Registry record updated Apr 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085003917 Issued in IL
Practice address
431 W Liberty St
Wauconda, IL 60084-2452
Phone
(847) 526-2151
Fax
(847) 526-2017
NPI assigned
Oct 6, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2014

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 085003917 IL Primary

Addresses

Primary practice location

431 W Liberty St
Wauconda, IL 60084-2452

Mailing address

431 W Liberty St
Wauconda, IL 60084-2452
Phone (847) 526-2151

Other names 1

  • Miss Kimberly Blezien 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
I20110519000368 IL Practitioner - Physician Assistant 7214113695

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

431 W Liberty St
Wauconda, IL 60084-2452

900 Rand Rd
Suite 300
Des Plaines, IL 60016-2359

Merit-based Incentive Payment System (MIPS)

Final score
81.07 of 100Reported as group
Quality
76.54
Promoting interoperability
83
Improvement activities
40
Cost
74.52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085003917ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Bone and Joint Institute, LLC CurrentSince Jul 11, 2016 Accepting new patients
Illinois Bone and Joint Institute LLC CurrentSince Jul 11, 2016 Accepting new patients

Locations

2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096

5057 Paysphere Cir
Chicago, IL 60674

900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090

720 Florsheim Dr
Libertyville, IL 60048
Phone (847) 247-4000

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": "1286323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1174832257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 W LIBERTY ST",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600842452",
            "telephone_number": "847-526-2151",
            "fax_number": "847-526-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 W LIBERTY ST",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600842452",
            "telephone_number": "847-526-2151",
            "fax_number": "847-526-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWARBRICK",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-06",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "BLEZIEN",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wauconda, IL

Sources for this page

Verify at the official NPI Registry.