Mayra Kiscellus, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209-05861 Issued in IL

Practice address

2350 Royal Blvd Ste 100
Elgin, IL 60123-4718

Phone

(847) 695-8100

NPI assigned

Jun 17, 2022

Last updated

Dec 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CMC Healthcare LLCGroup PAC ID 4688039209, 133 clinicians

Elio M Vento MD and Associates SCGroup PAC ID 4284688748, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Suncrest Hospice Illinois LLC Hospice, Northbrook, IL, CCN 141696
• Advocate Sherman Hospital Hospital, Elgin, IL, CCN 140030
• Saint Joseph Hospital-Elgin Hospital, Elgin, IL, CCN 140217

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21874/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/FDBJBA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• CMC Healthcare LLC

  • Nurse Practitioner
  • Evanston, IL
  • NPI 1295432334
  Medicare reassignment Care Compare group NPD
• Elio M Vento MD & Associates SC

  • Internal Medicine Physician
  • Elgin, IL
  • NPI 1063635431
  Medicare reassignment Care Compare group NPD
• Cardinalight Health, LLC

  • Family Nurse Practitioner
  • Crystal Lake, IL
  • NPI 1760956726
  NPD (past)
• Hospital Medicine Consultants LLC

  • Hospitalist Physician
  • Elgin, IL
  • NPI 1831424936
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate Sherman Hospital

  • General Acute Care Hospital
  • Elgin, IL
  • NPI 1629026364
  Care Compare affiliation
• Saint Joseph Hospital - Elgin LLC

  • General Acute Care Hospital
  • Elgin, IL
  • NPI 1922846351
  Care Compare affiliation
• Sherman Hospital

  • Skilled Nursing Facility
  • Elgin, IL
  • NPI 1275584302

  Hospital

  Care Compare affiliation
• Suncrest Hospice Illinois LLC

  dba Suncrest Hospice

  • Community Based Hospice Care Agency
  • Northbrook, IL
  • NPI 1003340050
  Care Compare affiliation

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

{
    "created_epoch": "1655424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1427789783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 W HIGGINS RD STE 140",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601692422",
            "telephone_number": "847-781-3100",
            "fax_number": "847-781-5156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 ROYAL BLVD STE 100",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601234718",
            "telephone_number": "847-695-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISCELLUS",
        "first_name": "MAYRA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-17",
        "last_updated": "2024-12-18",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-05861",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041381391",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Yoo Mee Kim, PHARMD
• Soo Y Kim, M.D.
• Nicole B Kinberg, APRN
• Kinder Healthcare Inc.
• Emily J Kirwin
• Emily Rose Kist, FNP
• Gabi Kitchell
• Shani Bethany Klapheck
• Amy Klaus, PA-C
• Julia Kleinfall, AUD

• Family Nurse Practitioner in Elgin, IL
• Providers in Elgin, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.