Mayya Woodall, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085.005825 Issued in IL

Practice address

211 E Army Trail Rd
Bloomingdale, IL 60108-2105

Phone

(630) 582-8946

Fax

(630) 582-0969

NPI assigned

Jun 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

State licenses

Practice roles

Locations

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.

• Northwestern Medical Faculty Foundation

  • Multi-Specialty Clinic/Center
  • Carol Stream, IL
  • NPI 1346235314
  Medicare reassignment NPD
• American Current Care of Illinois PC

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1285071241

  IL

  Medicare reassignment NPD
• Northwestern Medical Faculty Foundation

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1417718479
  NPD

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503014400000",
    "number": "1386092286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 W MAIN ST",
            "address_2": "SUITE M",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E ARMY TRAIL RD",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082105",
            "telephone_number": "630-582-8946",
            "fax_number": "630-582-0969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODALL",
        "first_name": "MAYYA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2017-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.005825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wohl Eye Center SC
• Lisa G Wohl, MD
• Elizabeth Wojcicki, DDS
• Jacqueline Lee Wolfe, LCSW
• Womens Doc of Bloomingdale S.C.
• Kylie Yang
• Humera Yasmin
• Zafeer Berki
• Jenifer Zagal
• Julie Ann Zakutansky, DC

• Physician Assistant in Bloomingdale, IL
• Providers in Bloomingdale, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.