Individual provider Active NPI

Anna Maria Lasota, NP-C

  • Nurse Practitioner
  • Skokie, IL
National Provider Identifier
1235804196
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209022658 Issued in IL
Practice address
9650 Gross Point Rd
Skokie, IL 60076-5080
Phone
(847) 864-3278
Fax
(847) 676-1727
NPI assigned
Aug 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209022658 IL Primary
Family Nurse Practitioner 363LF0000X 209.022658 IL

Addresses

Primary practice location

9650 Gross Point Rd
Skokie, IL 60076-5080

Mailing address

9650 Gross Point Rd
Skokie, IL 60076-5080
Phone (847) 864-3278

Other practice location 1

1875 Dempster St Ste 525
Park Ridge, IL 60068-1130
Phone (847) 698-5500

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address alasota247074@direct.myadvocateaurora.org

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
I20220216000213 IL Practitioner - Nurse Practitioner 2769875749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

9600 Gross Point Rd
Skokie, IL 60076-1214

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Swedish Hospital Hospital, Chicago, IL, CCN 140114
  • Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209022658ILMDNurse Practitioner
209.022658ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Apr 5, 2023 Accepting new patients
Endeavor Health Medical Group CurrentSince Apr 5, 2023 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

1875 W Dempster St
Ste 525
Park Ridge, IL 60068
Phone (847) 698-3600

9650 Gross Point Rd
Skokie, IL 60076
Phone (224) 251-1160

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.

Hospital & facility affiliations 5

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": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1235804196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9650 GROSS POINT RD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600765080",
            "telephone_number": "847-864-3278",
            "fax_number": "847-676-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9650 GROSS POINT RD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600765080",
            "telephone_number": "847-864-3278",
            "fax_number": "847-676-1727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1875 Dempster St Ste 525",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681130",
            "country_code": "US",
            "telephone_number": "847-698-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LASOTA",
        "first_name": "ANNA",
        "middle_name": "MARIA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209022658",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.022658",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1875 Dempster St Ste 525",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alasota247074@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "1875 Dempster St Ste 525",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.