Individual provider Active NPI

Andrew Ray Grover, PA-C

  • Medical Physician Assistant
  • Lake Barrington, IL
National Provider Identifier
1306141338
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085.003951 Issued in IL
Practice address
22285 N. Pepper Road
Suite 401
Lake Barrington, IL 60010-2538
Phone
(847) 882-6604
Fax
(847) 882-6228
NPI assigned
Jan 23, 2011
Last updated
Dec 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085.003951 IL Primary

Addresses

Primary practice location

22285 N. Pepper Road
Suite 401
Lake Barrington, IL 60010-2538

Mailing address

22285 N. Pepper Road
Suite 401
Lake Barrington, IL 60010-2538
Phone (847) 882-6604

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
I20110503000843 IL Practitioner - Physician Assistant 0143405324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Neurology, LTDGroup PAC ID 8729069158, 30 clinicians

Practice addresses (Care Compare)

22285 N Pepper Rd
Suite 401
Lake Barrington, IL 60010-2542
Phone 84788266042191

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085.003951ILMDMedical Physician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1295740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1306141338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22285 N. PEPPER ROAD",
            "address_2": "SUITE 401",
            "city": "LAKE BARRINGTON",
            "state": "IL",
            "postal_code": "600102538",
            "telephone_number": "847-882-6604",
            "fax_number": "847-882-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22285 N. PEPPER ROAD",
            "address_2": "SUITE 401",
            "city": "LAKE BARRINGTON",
            "state": "IL",
            "postal_code": "600102538",
            "telephone_number": "847-882-6604",
            "fax_number": "847-882-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVER",
        "first_name": "ANDREW",
        "middle_name": "RAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-23",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.003951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Barrington, IL

Sources for this page

Verify at the official NPI Registry.