Individual provider Active NPI

Olivia M Niepsuj, PA-C

  • Physician Assistant
  • Lake Forest, IL
National Provider Identifier
1245887256
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085007686 Issued in IL
Practice address
800 N Westmoreland Rd Ste 100
Lake Forest, IL 60045-1671
Phone
(847) 535-7657
Fax
(847) 998-9303
NPI assigned
Aug 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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 085007686 IL Primary

Addresses

Primary practice location

800 N Westmoreland Rd Ste 100
Lake Forest, IL 60045-1671

Mailing address

800 N Westmoreland Rd Ste 100
Lake Forest, IL 60045-1671
Phone (847) 535-7657

Other practice location 1

2701 Patriot Blvd
Glenview, IL 60026-8039
Phone (847) 535-7657

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address olivianiepsuj@uropart.allscriptsdirect.net

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
I20201012000899 IL Practitioner - Physician Assistant 5597185603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1000 N Westmoreland Rd
Pavillion B 3Rd FL
Lake Forest, IL 60045-1659
Phone (847) 535-8500

1000 Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-5600

1200 N Westmoreland Rd
Suite 100
Lake Forest, IL 60045-1601
Phone (847) 735-8500

600 N Westmoreland Rd
Suite 1100
Lake Forest, IL 60045-1659
Phone (847) 535-9510

660 N Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-5600

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

800 N W Moreland Rd
Suite 102
Lake Forest, IL 60045-1687
Phone (847) 582-2104

800 N Westmoreland Rd
Suite 201
Lake Forest, IL 60045-1687
Phone (847) 535-7647

870 N Milwaukee Ave
Vernon Hills, IL 60061-1521

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085007686ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Feb 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Feb 1, 2022 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

676 N Saint Clair St
Ste 1835
Chicago, IL 60611
Phone (312) 926-0883

2701 Patriot Blvd
Glenview, IL 60026
Phone (847) 724-4536

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

800 N Westmoreland Rd
Ste 100
Lake Forest, IL 60045
Phone (847) 535-6083

1000 N Westmoreland Rd
Lake Forest, IL 60045
Phone (847) 535-6150

Organizations & group practices 3

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": "1566518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1245887256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD STE 100",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451671",
            "telephone_number": "847-535-7657",
            "fax_number": "847-998-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD STE 100",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451671",
            "telephone_number": "847-535-7657",
            "fax_number": "847-998-9303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 Patriot Blvd",
            "address_purpose": "LOCATION",
            "city": "Glenview",
            "state": "IL",
            "postal_code": "600268039",
            "country_code": "US",
            "telephone_number": "847-535-7657",
            "fax_number": "847-998-9102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIEPSUJ",
        "first_name": "OLIVIA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "olivianiepsuj@uropart.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "676 N Saint Clair St Ste 1835",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606113129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

Verify at the official NPI Registry.