Individual provider Active NPI

Stacy A Baum, P.A.

  • Physician Assistant
  • South Elgin, IL
National Provider Identifier
1386899458
Registry record updated Jun 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085003350 Issued in IL
Practice address
552 Randall Rd
South Elgin, IL 60177
Phone
(630) 315-6700
Fax
(630) 315-6699
NPI assigned
Nov 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085.003350 IL
Physician Assistant 363A00000X 085003350 IL Primary

Addresses

Primary practice location

552 Randall Rd
South Elgin, IL 60177

Mailing address

25 N Winfield Rd
Winfield, IL 60190-1295
Phone (630) 315-6700

Other practice location 1

200 Fox Glen
Barrington, IL 60010-1809
Phone (847) 726-0774

Other identifiers 2

IdentifierTypeStateIssuer
F400473831OtherILINDIVIDUAL MEDICARE
920540OtherILGROUP 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
I20100223000785 IL Practitioner - Physician Assistant 0840334231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

552 Randall Rd
South Elgin, IL 60177-3315
Phone (630) 315-6700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085003350ILMDPhysician Assistant
085.003350ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Jun 18, 2018 Accepting new patients
Northwestern Medical Faculty Foundation Past Accepting new patients

Locations

820 S State Route 59
Ste A
Bartlett, IL 60103
Phone (630) 483-5930

231 S Gary Ave
Ste 100
Bloomingdale, IL 60108
Phone (630) 893-9600

360 Station Dr
Ste 300A
Crystal Lake, IL 60014
Phone (815) 788-7500

885 Roosevelt Rd
Ste 100
Glen Ellyn, IL 60137
Phone (630) 384-6200

10350 Haligus Rd
Ste A
Huntley, IL 60142
Phone (815) 455-6100

2507 N Richmond Rd
Ste B
McHenry, IL 60051
Phone (815) 206-7500

636 Raymond Dr
Ste 107
Naperville, IL 60563
Phone (630) 359-8396

552 Randall Rd
South Elgin, IL 60177
Phone (630) 315-6700

2900 Foxfield Rd
Ste 100
St Charles, IL 60174
Phone (630) 377-6500

7 Blanchard Cir
Ste 102
Wheaton, IL 60189
Phone (630) 510-9009

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Organizations & group practices 3

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.

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": "1226880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1386899458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901295",
            "telephone_number": "630-315-6700",
            "fax_number": "630-315-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 RANDALL RD",
            "city": "SOUTH ELGIN",
            "state": "IL",
            "postal_code": "60177",
            "telephone_number": "630-315-6700",
            "fax_number": "630-315-6699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Fox Glen",
            "address_purpose": "LOCATION",
            "city": "Barrington",
            "state": "IL",
            "postal_code": "600101809",
            "country_code": "US",
            "telephone_number": "847-726-0774",
            "fax_number": "847-726-0774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUM",
        "first_name": "STACY",
        "middle_name": "A",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-17",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.003350",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL MEDICARE",
            "identifier": "F400473831",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "920540",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Elgin, IL

Sources for this page

Verify at the official NPI Registry.