Individual provider Active NPI

David Eugene Wester, PA-C

  • Physician Assistant
  • Rockford, IL
National Provider Identifier
1386618478
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085001296 Issued in NU
Practice address
3413 Colony Bay Dr
Rockford, IL 61109-2560
Phone
(779) 368-0757
Fax
(779) 368-0758
NPI assigned
Feb 15, 2006
Last updated
Jan 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085001296 NU Primary

Addresses

Primary practice location

3413 Colony Bay Dr
Rockford, IL 61109-2560

Mailing address

3413 Colony Bay Dr
Rockford, IL 61109-2560
Phone (779) 368-0757

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
I20091020000203 IL Practitioner - Physician Assistant 4082751334

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Everside Health, LLC PastSince Sep 28, 2025 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1386618478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3413 COLONY BAY DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611092560",
            "telephone_number": "779-368-0757",
            "fax_number": "779-368-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3413 COLONY BAY DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611092560",
            "telephone_number": "779-368-0757",
            "fax_number": "779-368-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTER",
        "first_name": "DAVID",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": "085001296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.