Fortesa Myha, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085006125 Issued in IL

Practice address

800 Biesterfield Rd Ste G01
Elk Grove Village, IL 60007-3372

Phone

(847) 981-3680

Fax

(847) 956-5122

NPI assigned

Oct 3, 2012

Last updated

Dec 8, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: fortesa.myhapa.p3@direct.cvr.nextgenshare.com

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.

• Physicians Immediate Care North Chicago LLC

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1205814118
  Medicare reassignment
• Wellnow Urgent Care, PC

  dba WellNow Urgent Care

  • Urgent Care Clinic/Center
  • Liverpool, NY
  • NPI 1669825162

  IL

  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512691200000",
    "number": "1366794190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S FRONTAGE RD STE 325",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605174907",
            "telephone_number": "630-972-8228",
            "fax_number": "630-972-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD STE G01",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073372",
            "telephone_number": "847-981-3680",
            "fax_number": "847-956-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYHA",
        "first_name": "FORTESA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-03",
        "last_updated": "2017-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC GROUP PTAN",
            "identifier": "DS2377",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PRACTICE NPI",
            "identifier": "1720371669",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Murphy, D.O.
• Jeffrey A. Murray, M.D.
• Patricia Marie Murray, NP
• David S Muzic, MD
• Myeyedr Optometry of Illinois, LLC (MyEyeDr)
• Parviz Nabavi, M.D.
• Bhagyashree P Nadgir, PT
• Soumya Naduvile Naduvile Veetil
• Bryanna Nance
• Lawrence Thomas Nash, MD

• Physician Assistant in Elk Grove Village, IL
• Providers in Elk Grove Village, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.