NPIMap

Individual provider Active NPI

Kailie Morgan Seneczko, PA-C

  • Physician Assistant
  • Naperville, IL
National Provider Identifier
1407295363
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
85.004741 Issued in IL
Practice address
808 Rickert Dr Ste 103
Naperville, IL 60540-0908
Phone
(331) 551-5854
NPI assigned
Jun 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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 85.004741 IL Primary

Addresses

Primary practice location

808 Rickert Dr Ste 103
Naperville, IL 60540-0908

Mailing address

1860 Paysphere Cir
Chicago, IL 60674-8205
Phone (630) 469-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kseneczko193018@direct.edward.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131007000560 IL Practitioner - Physician Assistant 4587898598 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
97.45
Improvement activities
40

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
85.004741ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai Community Foundation CurrentSince May 10, 2014 Accepting new patients
Cepamerica Illinois LLP CurrentSince Sep 10, 2017 Accepting new patients
Aurora Emergency Physicians, LLC CurrentSince Sep 1, 2022 Accepting new patients
Cepamerica Illinois LLP CurrentSince Sep 10, 2017 Accepting new patients
Dupage Medical Group LTD CurrentSince Jun 3, 2019 Accepting new patients
Mount Sinai Community Foundation CurrentSince May 10, 2014 Accepting new patients
Dupage Medical Group LTD CurrentSince Jun 3, 2019 Accepting new patients

Locations

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

2000 Ogden Ave
Aurora, IL 60504
Phone (630) 466-8200

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

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

808 Rickert Dr
Ste 103
Naperville, IL 60540
Phone (331) 551-5854

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

Interoperability endpoints

  • Direct secure messaging: kseneczko193018@dulyhealthandcare.direct-ci.com

Organizations & group practices 10

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": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1407295363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606748205",
            "telephone_number": "630-469-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 RICKERT DR STE 103",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605400908",
            "telephone_number": "331-551-5854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENECZKO",
        "first_name": "KAILIE",
        "middle_name": "MORGAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-24",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "85.004741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kseneczko193018@direct.edward.org",
            "affiliation": "N",
            "address_1": "808 Rickert Dr Ste 103",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605400908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.