Daniela Cvetkova, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085005467 Issued in IL

Practice address

915 S Waukegan Rd
Lake Forest, IL 60045-2654

Phone

(847) 234-8866

Fax

(847) 234-4682

NPI assigned

Mar 2, 2012

Last updated

Aug 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Daniela Cvetkova Former name

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

Specialty

Physician Assistant

Education

Other, 2015

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)

Hospital & facility affiliations

• Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Allergy & Immunology Physician
  • Evanston, IL
  • NPI 1497701882
  Medicare reassignment Care Compare group
• North Suburban Family Physicians SC

  dba North Suburban Family Physicians

  • Clinic/Center
  • Libertyville, IL
  • NPI 1740635432
  Medicare reassignment
• Oak Street Health Physicians Group, PC

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1083051643
  Medicare reassignment
• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD
• Marsh Dermatology, SC

  • MOHS-Micrographic Surgery Physician
  • Libertyville, IL
  • NPI 1932388865
  NPD (past)
• Northwestern Medical Faculty Foundation

  dba Northwestern Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1417718479
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Endeavor Health Clinical Operations

  dba Endeavor Health Evanston Hospital

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1184670549
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1548534977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 S WAUKEGAN RD",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600452654",
            "telephone_number": "847-234-8866",
            "fax_number": "847-234-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 S WAUKEGAN RD",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600452654",
            "telephone_number": "847-234-8866",
            "fax_number": "847-234-4682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3021 Falling Waters",
            "address_purpose": "LOCATION",
            "city": "Lindenhurst",
            "state": "IL",
            "postal_code": "60046",
            "country_code": "US",
            "telephone_number": "847-356-9300",
            "fax_number": "847-356-7260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CVETKOVA",
        "first_name": "DANIELA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-02",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005467",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085005467",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELA",
            "last_name": "CVETKOVA",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Russell Creath Sr., M.D.
• Meghan M Crimmins, AU.D.
• Kristine Cuaresma
• Kyle T Cummisford, PA-C
• Rebecca Lockhart Curry-Edwards, AGACNP-BC
• Kristin Marie D'Silva, M.D.
• Deepak P Dalia, MD
• Daniel Joseph Dammrich, M.D.
• Jennifer Ann Daniels, MA
• Tricia Valters Danz, O.D.

• Physician Assistant in Lake Forest, IL
• Providers in Lake Forest, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.