Active NPI
Sarah Masri, PA-C, CAQ PSYCHIATRY
- Physician Assistant
- Lisle, IL
National Provider Identifier
1457780991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085.004879
- Practice address
- 4300 Commerce CT Ste 250
Lisle, IL 60532-3674 - Phone
- (630) 730-5506
- NPI assigned
- Nov 5, 2013
- Last updated
- Jun 7, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085.004879 | IL | Primary |
Addresses
Primary practice location
4300 Commerce CT Ste 250
Lisle, IL 60532-3674
Mailing address
4300 Commerce CT Ste 250
Lisle, IL 60532-3674
Phone (630) 730-5506
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 7, 2022 through Nov 7, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.004879 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lott Behavioral Health, LTD. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Lisle, IL
- NPI 1558808923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686096000000",
"number": "1457780991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 COMMERCE CT STE 250",
"city": "LISLE",
"state": "IL",
"postal_code": "605323674",
"telephone_number": "630-730-5506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 COMMERCE CT STE 250",
"city": "LISLE",
"state": "IL",
"postal_code": "605323674",
"telephone_number": "630-730-5506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASRI",
"first_name": "SARAH",
"credential": "PA-C, CAQ PSYCHIATRY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-05",
"last_updated": "2023-06-07",
"certification_date": "2023-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085.004879",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lisle, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.