Individual provider Active NPI

Amanda L Frakes, PA

  • Physician Assistant
  • Algonquin, IL
National Provider Identifier
1275727315
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085006483 Issued in IL
Practice address
650 S Randall Rd
Algonquin, IL 60102-5944
Phone
(815) 398-9491
Fax
(815) 381-7498
NPI assigned
Aug 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085006483 IL Primary
Physician Assistant 363A00000X 10001053A IN

Addresses

Primary practice location

650 S Randall Rd
Algonquin, IL 60102-5944

Mailing address

Box 78534
Milwaukee, WI 53278-8534
Phone (815) 398-9491

Other identifiers 4

IdentifierTypeStateIssuer
000000600746OtherINANTHEM
300005114MedicaidIN
085006483OtherILILLINOIS PHYSICIAN ASSISTANT LICENSE
P01291690OtherINRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Frakes.Amanda@ro.eclinicaldirect.com 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
I20180309000560 IL Practitioner - Physician Assistant 6406949247 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomidwest, PLLC CurrentSince Sep 1, 2020 Accepting new patients
Orthomidwest, PLLC CurrentSince Sep 1, 2020 Accepting new patients

Locations

650 S Randall Rd
Algonquin, IL 60102
Phone (779) 771-7000

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

5875 E Riverside Blvd
Rockford, IL 61114
Phone (779) 774-1270

Interoperability endpoints

  • Direct secure messaging: frakes.amanda@ro.eclinicaldirect.com

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": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1275727315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 78534",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532788534",
            "telephone_number": "815-398-9491",
            "fax_number": "815-381-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 S RANDALL RD",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601025944",
            "telephone_number": "815-398-9491",
            "fax_number": "815-381-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAKES",
        "first_name": "AMANDA",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-31",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006483",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001053A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000600746",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300005114",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS PHYSICIAN ASSISTANT LICENSE",
            "identifier": "085006483",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01291690",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Frakes.Amanda@ro.eclinicaldirect.com",
            "affiliation": "N",
            "endpointDescription": "eCW email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "650 S Randall Rd",
            "city": "Algonquin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601025944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Algonquin, IL

Sources for this page

Verify at the official NPI Registry.