Individual provider Active NPI

Deborah A Hassman, N.P.

  • Nurse Practitioner
  • Geneva, IL
National Provider Identifier
1275754061
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Practice address
300 Randall Rd
Emergency Dept
Geneva, IL 60134-4200
Phone
(630) 208-4009
Fax
(630) 208-0942
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X IL Primary

Addresses

Primary practice location

300 Randall Rd
Emergency Dept
Geneva, IL 60134-4200

Mailing address

300 Randall Rd
Emergency Dept
Geneva, IL 60134-4200
Phone (630) 208-4009

Other identifiers 1

IdentifierTypeStateIssuer
0451530938OtherILBLUE SHIELD

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
I20070627000324 IL Practitioner - Nurse Practitioner 3870692130 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-County Emergency Physicians LTDGroup PAC ID 2567412240, 18 clinicians
Crystal Lake Immediate Care Physicians LTD.Group PAC ID 2961783139, 17 clinicians

Practice addresses (Care Compare)

450 W Hwy 22
Barrington, IL 60010-1919
Phone (877) 346-2211

525 E Congress Pkwy
Suite 100
Crystal Lake, IL 60014-6271
Phone (626) 327-6795

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209004844ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Lake Immediate Care Physicians LTD. CurrentSince Oct 18, 2019 Accepting new patients
Tri-County Emergency Physicians, LTD CurrentSince Oct 18, 2019 Accepting new patients
Advocate Health and Hospitals Corporation PastSince Oct 18, 2019 Accepting new patients

Locations

525 E Congress Pkwy
Ste 100
Crystal Lake, IL 60014
Phone (626) 327-6795

450 W State Route 22
South Barrington, IL 60010
Phone (847) 381-0123

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.

Hospital & facility affiliations 1

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1275754061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 RANDALL RD",
            "address_2": "EMERGENCY DEPT",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344200",
            "telephone_number": "630-208-4009",
            "fax_number": "630-208-0942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RANDALL RD",
            "address_2": "EMERGENCY DEPT",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344200",
            "telephone_number": "630-208-4009",
            "fax_number": "630-208-0942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSMAN",
        "first_name": "DEBORAH",
        "middle_name": "A",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0451530938",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

Verify at the official NPI Registry.