NPIMap

Individual provider Active NPI

Jessica Bastidas, PA-C

  • Surgical Physician Assistant
  • Chicago, IL
National Provider Identifier
1205238367
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085005220 Issued in IL
Practice address
5215 N California Ave Ste F801
Chicago, IL 60625-7014
Phone
(847) 503-3000
Fax
(847) 503-3500
NPI assigned
Sep 20, 2014
Last updated
Apr 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.005220 IL
Surgical Physician Assistant 363AS0400X 085005220 IL Primary

Addresses

Primary practice location

5215 N California Ave Ste F801
Chicago, IL 60625-7014

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700
Phone (847) 982-6715

Other practice location 1

17495 La Grange Rd
Tinley Park, IL 60487-7581
Phone (630) 790-1221

Other names 1

  • Jessica Bastidas-Celleri Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbastidas260332@dulyhealthandcare.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150521001791 IL Practitioner - Physician Assistant 1850336900 Reassigns benefits to 7 organizations
I20180404000111 TX Practitioner - Physician Assistant 1850336900 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cook CountyGroup PAC ID 2860398088, 770 clinicians

Practice addresses (Care Compare)

1901 W Harrison St
Chicago, IL 60612-3714
Phone (312) 633-7292

500 E 51St St
Chicago, IL 60615-2494
Phone (312) 572-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.005220ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Medical Center of Illinois CurrentSince Jun 30, 2022 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Jun 30, 2022 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Jan 4, 2021 Accepting new patients
Mount Sinai Community Foundation CurrentSince Feb 1, 2015 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Jan 4, 2021 Accepting new patients
Dupage Medical Group LTD CurrentSince Apr 3, 2023 Accepting new patients
Dupage Medical Group LTD CurrentSince Apr 3, 2023 Accepting new patients
Cook County CurrentSince Jul 18, 2025 Accepting new patients
Cook County CurrentSince Jul 18, 2025 Accepting new patients
Mount Sinai Community Foundation CurrentSince Feb 1, 2015 Accepting new patients
Endeavor Health Medical Group Past Accepting new patients
Lincoln Pediatric Center, PC Past Accepting new patients

Locations

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 680-2402

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

17495 La Grange Rd
Tinley Park, IL 60487
Phone (708) 226-7000

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981

1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204

410 N M St
Hugo, OK 74743
Phone (580) 326-7561

902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600

1127 S George Nigh Expy
McAlester, OK 74501
Phone (918) 423-8400

109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100

2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636

Interoperability endpoints

  • Direct secure messaging: jbastidas239722@direct.myadvocateaurora.org
  • Direct secure messaging: jbastidas260332@dulyhealthandcare.direct-ci.com

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1411171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1205238367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-982-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 N CALIFORNIA AVE STE F801",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606257014",
            "telephone_number": "847-503-3000",
            "fax_number": "847-503-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17495 La Grange Rd",
            "address_purpose": "LOCATION",
            "city": "Tinley Park",
            "state": "IL",
            "postal_code": "604877581",
            "country_code": "US",
            "telephone_number": "630-790-1221",
            "fax_number": "630-653-1091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASTIDAS",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-20",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.005220",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085005220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbastidas260332@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17495 La Grange Rd",
            "city": "Tinley Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604877581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BASTIDAS-CELLERI",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.