Individual provider Active NPI

Alexis N Levitas, PA-C

  • Dermatology Physician
  • Buffalo Grove, IL
National Provider Identifier
1205485109
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
085007249 Issued in IL
Practice address
600 W Lake Cook Rd Ste 110
Buffalo Grove, IL 60089-2085
Phone
(847) 459-6611
NPI assigned
Sep 4, 2019
Last updated
May 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 085007249 IL Primary

Addresses

Primary practice location

600 W Lake Cook Rd Ste 110
Buffalo Grove, IL 60089-2085

Mailing address

600 W Lake Cook Rd Ste 110
Buffalo Grove, IL 60089-2085

Other practice location 1

600 W Lake Cook Rd Ste 110
Buffalo Grove, IL 60089-2085
Phone (847) 459-6611

Other identifiers 1

IdentifierTypeStateIssuer
085007249OtherILIDFPR

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Ema

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
I20200310001227 IL Practitioner - Physician Assistant 9133557960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott D Glazer MD SCGroup PAC ID 5890711642, 6 clinicians

Practice addresses (Care Compare)

1430 N Arlington Heights Rd
Suite 213
Arlington Heights, IL 60004-4825
Phone (847) 255-9150

600 W Lake Cook Rd
Suite 110
Buffalo Grove, IL 60089-2085
Phone (847) 459-6611

Merit-based Incentive Payment System (MIPS)

Final score
91.54 of 100Reported as group
Quality
71.81
Promoting interoperability
100
Improvement activities
40
Cost
100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
085007249ILMDDermatology Physician

Interoperability endpoints

  • Direct secure messaging: aemert@glazerdermatology.emadirect.md

Organizations & group practices 1

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": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1205485109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W LAKE COOK RD STE 110",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600892085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W LAKE COOK RD STE 110",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600892085",
            "telephone_number": "847-459-6611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 W Lake Cook Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Buffalo Grove",
            "state": "IL",
            "postal_code": "600892085",
            "country_code": "US",
            "telephone_number": "847-459-6611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVITAS",
        "first_name": "ALEXIS",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "085007249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDFPR",
            "identifier": "085007249",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Ema",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "address_1": "600 W Lake Cook Rd Ste 110",
            "city": "Buffalo Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600892085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Buffalo Grove, IL

Sources for this page

Verify at the official NPI Registry.