Doroty O.D.S. Devalon, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085-008125 Issued in IL

Practice address

2100 Glenwood Ave
Joliet, IL 60435-5487

Phone

(815) 725-2121

Fax

(815) 741-5518

NPI assigned

Oct 22, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wisconsin Spine and Pain SCGroup PAC ID 0345665469, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aurora Medical Ctr Washington County Hospital, Hartford, WI, CCN 520038
• Froedtert Memorial Lutheran Hospital Hospital, Milwaukee, WI, CCN 520177

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 and National Provider Directory roles.

• Wisconsin Spine and Pain SC

  • Interventional Pain Medicine Physician
  • Sheboygan, WI
  • NPI 1790309276
  Medicare reassignment Care Compare group NPD
• Dupage Medical Group LTD

  • Durable Medical Equipment & Medical Supplies
  • Glen Ellyn, IL
  • NPI 1760979447
  NPD
• Dupage Medical Group LTD

  • Multi-Specialty Clinic/Center
  • Downers Grove, IL
  • NPI 1801833983
  NPD
• Wisconsin Spine and Pain SC

  • Durable Medical Equipment & Medical Supplies
  • Appleton, WI
  • NPI 1285452391
  NPD
• Central Dupage Physical Medicine LT

  • Physical Medicine & Rehabilitation Physician
  • Carol Stream, IL
  • NPI 1528117090
  NPD (past)
• Algos Inc., a Medical Corporation

  • Pain Medicine Physician
  • Simi Valley, CA
  • NPI 1063890275
  NPD (past)

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

• Aurora Medical Center of Washington County, Inc.

  • General Acute Care Hospital
  • Hartford, WI
  • NPI 1760420103
  Care Compare affiliation
• Aurora Medical Center of Washington County, Inc.M

  • Clinic/Center
  • Hartford, WI
  • NPI 1306056056

  Hospital

  Care Compare affiliation
• Froedtert Memorial Lutheran Hospital, Inc.

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1255334173
  Care Compare affiliation

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1629544234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60677",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 GLENWOOD AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355487",
            "telephone_number": "815-725-2121",
            "fax_number": "815-741-5518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVALON",
        "first_name": "DOROTY",
        "middle_name": "O.D.S.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-22",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-008125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddevalon248638@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2100 Glenwood Ave",
            "city": "Joliet",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604355487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Frances Gulotta Deppe, MD
• Dermatology and Plastic Surgery Associates, S.C.
• Maryse Beaudouin Derosena, BS MHA LDN
• Des Plaines Physician Services, P.C.
• Paul M Desrosiers, MD
• Developmental and School Based Consultants LTD
• Katrina D Devers
• Zachary Ryan Devore, LPC
• Melanie Anne Dewey, LCPC
• Lucy Dey, M.D.

• Physician Assistant in Joliet, IL
• Providers in Joliet, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.