Individual provider Active NPI

Jessica Mancuso, PA

  • Physician Assistant
  • Winfield, IL
National Provider Identifier
1457864506
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085006382 Issued in IL
Practice address
25 N Winfield Rd Ste 2202
Winfield, IL 60190-1379
Phone
(630) 307-7799
Fax
(630) 307-2277
NPI assigned
Nov 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 085.006382 IL
Physician Assistant 363A00000X 085006382 IL Primary

Addresses

Primary practice location

25 N Winfield Rd Ste 2202
Winfield, IL 60190-1379

Mailing address

25 N Winfield Rd Ste 2202
Winfield, IL 60190-1379
Phone (630) 307-7799

Other practice location 1

4405 Weaver Pkwy
Warrenville, IL 60555-3269
Phone (630) 307-7799

Other practice location 2

304 Randall Rd
Geneva, IL 60134-4200
Phone (630) 307-7799

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jberg172614@direct.edward.org Direct

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
I20171211001679 IL Practitioner - Physician Assistant 8022376565 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

25 N Winfield Rd
Winfield, IL 60190-1295

300 Randall Rd
Geneva, IL 60134-4200
Phone (630) 933-4700

304 Randall Rd
Geneva, IL 60134-4200
Phone (630) 307-7799

4405 Weaver Pkwy
Warrenville, IL 60555-3269
Phone (630) 352-5580

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085006382ILMDPhysician Assistant
085.006382ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Health Ventures CurrentSince Nov 13, 2017 Accepting new patients
Edward Health Ventures CurrentSince Nov 13, 2017 Accepting new patients
Central Dupage Physician Group CurrentSince May 31, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2025 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2025 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

304 Randall Rd
Geneva, IL 60134
Phone (630) 232-0610

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

120 Spalding Dr
Ste 207
Naperville, IL 60540
Phone (630) 527-2700

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

120 Spalding Dr
Ste 205
Naperville, IL 60540
Phone (630) 527-5217

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

4405 Weaver Pkwy
Warrenville, IL 60555
Phone (630) 352-5450

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

25 N Winfield Rd
#2202
Winfield, IL 60190

25 N Winfield Rd
Ste 2202
Winfield, IL 60190
Phone (630) 352-5450

Organizations & group practices 7

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 3

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": "1510444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1457864506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD STE 2202",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901379",
            "telephone_number": "630-307-7799",
            "fax_number": "630-307-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD STE 2202",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901379",
            "telephone_number": "630-307-7799",
            "fax_number": "630-307-2277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4405 Weaver Pkwy",
            "address_purpose": "LOCATION",
            "city": "Warrenville",
            "state": "IL",
            "postal_code": "605553269",
            "country_code": "US",
            "telephone_number": "630-307-7799",
            "fax_number": "630-307-2277",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "304 Randall Rd",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "IL",
            "postal_code": "601344200",
            "country_code": "US",
            "telephone_number": "630-307-7799",
            "fax_number": "630-307-2277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCUSO",
        "first_name": "JESSICA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-12",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085.006382",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jberg172614@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "120 Spalding Dr Ste 205",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605406527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winfield, IL

Sources for this page

Verify at the official NPI Registry.