Individual provider Active NPI

Shareikka Lacole Griffin, PA-C

  • Physician Assistant
  • Crystal Lake, IL
National Provider Identifier
1396363644
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085007813 Issued in IL
Practice address
420 N Il Route 31
Crystal Lake, IL 60012-3709
Phone
(815) 356-5200
Fax
(815) 356-5262
NPI assigned
Jul 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X IL
Physician Assistant 363A00000X 085007813 IL Primary

Addresses

Primary practice location

420 N Il Route 31
Crystal Lake, IL 60012-3709

Mailing address

420 N Il Route 31
Crystal Lake, IL 60012-3709
Phone (815) 356-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200827003853 IL Practitioner - Physician Assistant 7719304351 Reassigns benefits to 2 organizations
I20250806004358 TX Practitioner - Physician Assistant 7719304351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

3417 Gaston Ave
Dallas, TX 75246-2030

3500 Gaston Ave
FL 1
Dallas, TX 75246-2017
Phone (972) 817-6100

4001 Worth St
Dallas, TX 75246-1608

Hospital & facility affiliations

  • Baylor University Medical Center Hospital, Dallas, TX, CCN 450021
  • Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

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
085007813ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Jul 28, 2025 Accepting new patients
Lake County Immediate Care, LLC CurrentSince Jan 3, 2025 Accepting new patients

Locations

1849 Green Bay Rd
Ste 171
Highland Park, IL 60035
Phone (847) 901-8400

724 N Green Bay Rd
Waukegan, IL 60085
Phone (847) 901-8400

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

Interoperability endpoints

  • Direct secure messaging: sgriffin1432343@direct.sw.org

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 and National Provider Directory roles.

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": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1396363644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 N IL ROUTE 31",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600123709",
            "telephone_number": "815-356-5200",
            "fax_number": "815-356-5262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N IL ROUTE 31",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600123709",
            "telephone_number": "815-356-5200",
            "fax_number": "815-356-5262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "SHAREIKKA",
        "middle_name": "LACOLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-13",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.