Individual provider Active NPI

Janette Marie Leveille, M.M.S., P.A.-C.

  • Physician Assistant
  • St Charles, IL
National Provider Identifier
1245638162
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.005348 Issued in IL
Practice address
3805 E Main St Ste M
St Charles, IL 60174-2487
Phone
(630) 646-5200
Fax
(630) 377-3762
NPI assigned
Dec 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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 085.005348 IL Primary

Addresses

Primary practice location

3805 E Main St Ste M
St Charles, IL 60174-2487

Mailing address

1335 N Mill St
Suite 100
Naperville, IL 60563-2047
Phone (630) 646-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jleveille46537@direct.edward.org Direct

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
I20150327001628 IL Practitioner - Physician Assistant 1658698865 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
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

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
085.005348ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Health Ventures CurrentSince Feb 1, 2015 Accepting new patients
Endeavor Health Medical Group CurrentSince Nov 30, 2023 Accepting new patients
Edward Health Ventures CurrentSince Feb 1, 2015 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

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

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

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

1335 N Mill St
Ste 100
Naperville, IL 60563
Phone (630) 305-5118

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

3805 E Main St
Ste M
St Charles, IL 60174
Phone (630) 377-3762

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.

NPI Registry JSON

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1245638162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 N MILL ST",
            "address_2": "SUITE 100",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632047",
            "telephone_number": "630-646-8000",
            "fax_number": "630-646-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 E MAIN ST STE M",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742487",
            "telephone_number": "630-646-5200",
            "fax_number": "630-377-3762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVEILLE",
        "first_name": "JANETTE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "M.M.S., P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-09",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.005348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jleveille46537@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3805 E Main St Ste M",
            "city": "St Charles",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601742487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

Verify at the official NPI Registry.