Individual provider Active NPI

Melissa Ann Peart, PAC

  • Physician Assistant
  • Lombard, IL
National Provider Identifier
1609102631
Registry record updated Jan 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1177 S Main St
Lombard, IL 60148-3952
Phone
(331) 221-2820
NPI assigned
Oct 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2017

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 Primary

Addresses

Primary practice location

1177 S Main St
Lombard, IL 60148-3952

Mailing address

1177 S Main St
Lombard, IL 60148-3952
Phone (331) 221-2820

Other names 1

  • Ms. Melissa Ann Denardo Former name

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
I20170427001404 IL Practitioner - Physician Assistant 1658658786 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

701 W N Ave
Melrose Park, IL 60160-1612
Phone (708) 681-3200

715 W N Ave
Melrose Park, IL 60160-1612
Phone (708) 450-4554

719 W N Ave
Melrose Park, IL 60160-1612
Phone (708) 538-6773

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Edward Health Ventures CurrentSince Mar 26, 2017 Accepting new patients
Loyola University Medical Center CurrentSince Nov 29, 2023 Accepting new patients
Edward Health Ventures CurrentSince Mar 26, 2017 Accepting new patients
Loyola University Medical Center CurrentSince Nov 29, 2023 Accepting new patients

Locations

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

1177 S Main St
Lombard, IL 60148
Phone (630) 629-5050

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

701 W North Ave
Melrose Park, IL 60160
Phone (708) 450-5779

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

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

24600 W 127th St
Ste B100
Plainfield, IL 60585
Phone (815) 731-9000

Organizations & group practices 4

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": "1256601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485043200000",
    "number": "1609102631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 S MAIN ST",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601483952",
            "telephone_number": "331-221-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 S MAIN ST",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601483952",
            "telephone_number": "331-221-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEART",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-27",
        "last_updated": "2017-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "DENARDO",
            "middle_name": "ANN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lombard, IL

Sources for this page

Verify at the official NPI Registry.