Individual provider Active NPI

Alice Stephanie Janiszewski, PA

  • Physician Assistant
  • Streamwood, IL
National Provider Identifier
1396460978
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085009286 Issued in IL
Practice address
140 Winchester Dr Unit B
Streamwood, IL 60107-2426
Phone
(630) 456-2758
NPI assigned
Oct 6, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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 085009286 IL Primary

Addresses

Primary practice location

140 Winchester Dr Unit B
Streamwood, IL 60107-2426

Mailing address

140 Winchester Dr Unit B
Streamwood, IL 60107-2426
Phone (630) 456-2758

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
I20221213001493 IL Practitioner - Physician Assistant 5890164925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.41 of 100Reported as group
Quality
86.81
Improvement activities
40
Cost
77.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085009286ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cepamerica Illinois LLP CurrentSince Dec 2, 2022 Accepting new patients
Cepamerica Illinois LLP CurrentSince Dec 2, 2022 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

600 S Randall Rd
Algonquin, IL 60102
Phone (224) 783-4300

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

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.

NPI Registry JSON

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1396460978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 WINCHESTER DR UNIT B",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601072426",
            "telephone_number": "630-456-2758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 WINCHESTER DR UNIT B",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601072426",
            "telephone_number": "630-456-2758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANISZEWSKI",
        "first_name": "ALICE",
        "middle_name": "STEPHANIE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-06",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085009286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Streamwood, IL

Sources for this page

Verify at the official NPI Registry.