Individual provider Active NPI

Joseph Mountain, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1205688967
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3300 N Claremont Ave Apt 2
Chicago, IL 60618-6232
Phone
(651) 999-9605
NPI assigned
Apr 4, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 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 Primary

Addresses

Primary practice location

3300 N Claremont Ave Apt 2
Chicago, IL 60618-6232

Mailing address

3300 N Claremont Ave Apt 2
Chicago, IL 60618-6232
Phone (651) 999-9605

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
I20241231000745 IL Practitioner - Physician Assistant 9931636057 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)

3303 W 26TH St
Chicago, IL 60623-4036
Phone (773) 277-6589

7450 W 63Rd St
Des Plaines Valley Family Health Center
Summit, IL 60501-1816
Phone (708) 458-0757

Hospital & facility affiliations

  • Mt Sinai Hospital Medical Center Hospital, Chicago, IL, CCN 140018
  • Schwab Rehabilitation Hospital Inpatient rehabilitation facility, Chicago, IL, CCN 143025

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Network CurrentSince Oct 24, 2024 Accepting new patients
Access Community Health Network CurrentSince Oct 24, 2024 Accepting new patients
Access Community Health Network Past Accepting new patients

Locations

600 W Fulton St
Ste 300
Chicago, IL 60661

3303 W 26th St
Chicago, IL 60623
Phone (773) 277-6589

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1205688967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 N CLAREMONT AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186232",
            "telephone_number": "651-999-9605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 N CLAREMONT AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186232",
            "telephone_number": "651-999-9605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUNTAIN",
        "first_name": "JOSEPH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.