Individual provider Active NPI

Judith M Rossbach, PA-C

  • Physician Assistant
  • Elgin, IL
National Provider Identifier
1396922936
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9111849 Issued in FL
Practice address
1530 N Randall Rd Ste 210
Elgin, IL 60123
Phone
(224) 760-7322
Fax
(224) 535-8252
NPI assigned
Jan 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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 085002280 IL
Physician Assistant 363A00000X PA9111849 FL Primary

Addresses

Primary practice location

1530 N Randall Rd Ste 210
Elgin, IL 60123

Mailing address

6400 Industrial Loop
Greendale, WI 53129-2452
Phone (414) 858-4106

Other practice location 1

4575 Weaver Pkwy
Warrenville, IL 60555-4039
Phone (630) 505-0300

Other practice location 2

10105 Bennington Dr
Tampa, FL 33626-2405
Phone (630) 212-3102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.11 of 100Reported as group
Quality
70.72
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3820AZMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1396922936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-858-4106",
            "fax_number": "414-423-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 N RANDALL RD STE 210",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "60123",
            "telephone_number": "224-760-7322",
            "fax_number": "224-535-8252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4575 Weaver Pkwy",
            "address_purpose": "LOCATION",
            "city": "Warrenville",
            "state": "IL",
            "postal_code": "605554039",
            "country_code": "US",
            "telephone_number": "630-505-0300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10105 Bennington Dr",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336262405",
            "country_code": "US",
            "telephone_number": "630-212-3102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSSBACH",
        "first_name": "JUDITH",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-25",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002280",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.