Individual provider Active NPI

Zachary A Stutzman, PA-C

  • Physician Assistant
  • Warrenville, IL
National Provider Identifier
1528462413
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085007592 Issued in IL
Practice address
27650 Ferry Rd Ste 100
Warrenville, IL 60555-3846
Phone
(630) 225-2663
Fax
(630) 225-2399
NPI assigned
Oct 21, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Physician Assistant 363A00000X 12524 MN
Physician Assistant 363A00000X 085007592 IL Primary

Addresses

Primary practice location

27650 Ferry Rd Ste 100
Warrenville, IL 60555-3846

Mailing address

27650 Ferry Rd Ste 100
Warrenville, IL 60555-3846
Phone (630) 225-2663

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address zachary.stutzman.1@380.direct.athenahealth.com

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
I20200422001474 IL Practitioner - Physician Assistant 5698041267 Reassigns benefits to 2 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

233 S Gary Ave
Bloomingdale, IL 60108-2213
Phone (630) 208-6775

25 N Winfield Rd
Winfield, IL 60190-1295

27650 Ferry Rd
Warrenville, IL 60555-3845
Phone (630) 225-2663

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

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

885 Roosevelt Rd
Glen Ellyn, IL 60137-6141

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
12524MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Dec 14, 2022 Accepting new patients

Locations

27650 Ferry Rd
Ste 100
Warrenville, IL 60555
Phone (630) 225-2455

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

Interoperability endpoints

  • Direct secure messaging: zachary.stutzman.1@380.direct.athenahealth.com

Organizations & group practices 3

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 5

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": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1528462413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27650 FERRY RD STE 100",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553846",
            "telephone_number": "630-225-2663",
            "fax_number": "630-225-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27650 FERRY RD STE 100",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553846",
            "telephone_number": "630-225-2663",
            "fax_number": "630-225-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUTZMAN",
        "first_name": "ZACHARY",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-21",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12524",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zachary.stutzman.1@380.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "396 Remington Blvd Ste 130",
            "city": "Bolingbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604404309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Warrenville, IL

Sources for this page

Verify at the official NPI Registry.