Individual provider Active NPI

Kam Mueller, PA-C

  • Physician Assistant
  • Glenview, IL
National Provider Identifier
1265943625
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085007933 Issued in IL
Practice address
2100 Pfingsten Rd Ste 2023
Glenview, IL 60026-1301
Phone
(717) 231-8772
Fax
(717) 231-8435
NPI assigned
Oct 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 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 085007933 IL Primary

Addresses

Primary practice location

2100 Pfingsten Rd Ste 2023
Glenview, IL 60026-1301

Mailing address

2100 Pfingsten Rd Ste 2023
Glenview, IL 60026-1301
Phone (717) 231-8772

Other practice location 1

111 S Front St
Harrisburg, PA 17101-2010
Phone (717) 231-8772

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmueller58761@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171209000112 PA Practitioner - Physician Assistant 5496013989 Reassigns benefits to 1 organization
I20210212000385 IL Practitioner - Physician Assistant 5496013989 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

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
085007933ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Jan 25, 2021 Accepting new patients
Howard Brown Health Center Past 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
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2100 Pfingsten Rd
Ste 2023
Glenview, IL 60026

Organizations & group practices 5

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": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1265943625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 PFINGSTEN RD STE 2023",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261301",
            "telephone_number": "717-231-8772",
            "fax_number": "717-231-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 PFINGSTEN RD STE 2023",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261301",
            "telephone_number": "717-231-8772",
            "fax_number": "717-231-8435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 S Front St",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171012010",
            "country_code": "US",
            "telephone_number": "717-231-8772",
            "fax_number": "717-231-8435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "KAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-12",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmueller58761@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "111 S Front St",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171012010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

Verify at the official NPI Registry.