NPIMap

Individual provider Active NPI

Cassandra Crackel, PA

  • Physician Assistant
  • Naperville, IL
National Provider Identifier
1538439799
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085004251 Issued in IL
Practice address
2007 95TH Street
Ste 112
Naperville, IL 60564-8561
Phone
(630) 527-7780
Fax
(630) 527-7777
NPI assigned
Jan 5, 2012
Last updated
Jan 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085004251 IL Primary

Addresses

Primary practice location

2007 95TH Street
Ste 112
Naperville, IL 60564-8561

Mailing address

2007 95TH Street
Ste 112
Naperville, IL 60564-8561
Phone (630) 527-7780

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ccrackel15380@direct.edward.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120225000074 IL Practitioner - Physician Assistant 6204094022 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2007 95TH St
Naperville, IL 60564-8459
Phone (630) 527-3200

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085004251ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Health Ventures CurrentSince Jan 21, 2012 Accepting new patients
Edward Health Ventures CurrentSince Jan 21, 2012 Accepting new patients
Endeavor Health Medical Group Past Accepting new patients

Locations

2007 95th St
Ste 112
Naperville, IL 60564
Phone (630) 527-7780

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1538439799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 95TH STREET",
            "address_2": "STE 112",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648561",
            "telephone_number": "630-527-7780",
            "fax_number": "630-527-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 95TH STREET",
            "address_2": "STE 112",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648561",
            "telephone_number": "630-527-7780",
            "fax_number": "630-527-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRACKEL",
        "first_name": "CASSANDRA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-05",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccrackel15380@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ccrackel15380@direct.edward.org",
            "address_1": "2007 95th Street",
            "address_2": "Ste 112",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605648561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.