Individual provider Active NPI

Fayette Powers Wernick, PA-C

  • Physician Assistant
  • Oakbrook Terrace, IL
National Provider Identifier
1437115706
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085004332 Issued in IL
Practice address
1S450 Summit Ave Ste 165
Oakbrook Terrace, IL 60181-3952
Phone
(630) 320-6871
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110002200 VA
Medical Physician Assistant 363AM0700X PA030489 DC
Physician Assistant 363A00000X 085004332 IL Primary

Addresses

Primary practice location

1S450 Summit Ave Ste 165
Oakbrook Terrace, IL 60181-3952

Mailing address

1S450 Summit Ave Ste 165
Oakbrook Terrace, IL 60181-3952
Phone (630) 320-6871

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
I20220210000440 IL Practitioner - Physician Assistant 9436171865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Home Physicians LLCGroup PAC ID 4981988771, 81 clinicians

Practice addresses (Care Compare)

1 S450 Summit Ave
Suite 165
Oakbrook Terrace, IL 60181-3952
Phone (630) 320-6871

Hospital & facility affiliations

  • Copley Memorial Hospital Hospital, Aurora, IL, CCN 140029

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085004332ILMDPhysician Assistant
0110002200VAMDPhysician Assistant

Organizations & group practices 1

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 1

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1437115706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1S450 SUMMIT AVE STE 165",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813952",
            "telephone_number": "630-320-6871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1S450 SUMMIT AVE STE 165",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813952",
            "telephone_number": "630-320-6871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNICK",
        "first_name": "FAYETTE",
        "middle_name": "POWERS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002200",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DC",
            "license": "PA030489",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakbrook Terrace, IL

Sources for this page

Verify at the official NPI Registry.