Individual provider Active NPI

Joshua Wade, PA

  • Physician Assistant
  • Sterling, IL
National Provider Identifier
1386724235
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
101 E Miller Rd
Sterling, IL 61081-1252
Phone
(815) 625-4790
NPI assigned
Oct 16, 2006
Last updated
Dec 11, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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 IL Primary

Addresses

Primary practice location

101 E Miller Rd
Sterling, IL 61081-1252

Mailing address

101 E Miller Rd
Sterling, IL 61081-1252
Phone (815) 625-4790

Other identifiers 2

IdentifierTypeStateIssuer
098068OtherILHEALTH ALLIANCE PLAN
P00161840OtherRAILROAD MEDICARE

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
I20041209000652 IL Practitioner - Physician Assistant 3375509425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CGH Medical CenterGroup PAC ID 6103723267, 199 clinicians

Practice addresses (Care Compare)

100 E Le Fevre Rd
Sterling, IL 61081-1278
Phone (815) 625-0400

100 E Lefevre Rd
Sterling, IL 61081-1278

101 E Miller Rd
Sterling, IL 61081-1252
Phone (815) 625-4790

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085002306ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
CGH Medical Center CurrentSince Oct 1, 2011 Accepting new patients
CGH Medical Center CurrentSince Oct 1, 2011 Accepting new patients
CGH Medical Center Current Accepting new patients
CGH Medical Center Past Accepting new patients

Locations

711 S Division Ave
Polo, IL 61064
Phone (815) 946-3661

101 E Miller Rd
Sterling, IL 61081
Phone (815) 632-5285

1809 Locust St
Sterling, IL 61081
Phone (815) 564-4002

Interoperability endpoints

  • Direct secure messaging: jwade20253@cghmc.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1386724235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E MILLER RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811252",
            "telephone_number": "815-625-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E MILLER RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811252",
            "telephone_number": "815-625-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "JOSHUA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN",
            "identifier": "098068",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00161840",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, IL

Sources for this page

Verify at the official NPI Registry.