Individual provider Active NPI

Meghann Reid Vizintos, PA-C

  • Physician Assistant
  • Naperville, IL
National Provider Identifier
1629619275
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
85007364 Issued in IL
Practice address
1763 Freedom Dr Ste 117
Naperville, IL 60563
Phone
(630) 687-9595
NPI assigned
Oct 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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 85007364 IL Primary

Addresses

Primary practice location

1763 Freedom Dr Ste 117
Naperville, IL 60563

Mailing address

1763 Freedom Dr Ste 117
Naperville, IL 60563-3553
Phone (630) 687-9595

Other practice location 1

4S727 Karns Rd
Naperville, IL 60563-1506
Phone (630) 577-7095

Other practice location 2

1763 Freedom Dr Ste 117
Naperville, IL 60563
Phone (630) 687-9595

Other identifiers 1

IdentifierTypeStateIssuer
85007364OtherILILLINOIS PA LICENSE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231222001491 IL Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/Gynecology 9133579766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
85007364ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Wright Center for Women'S Health Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1629619275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1763 FREEDOM DR STE 117",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605633553",
            "telephone_number": "630-687-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1763 FREEDOM DR STE 117",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "60563",
            "telephone_number": "630-687-9595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4S727 Karns Rd",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605631506",
            "country_code": "US",
            "telephone_number": "630-577-7095",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1763 Freedom Dr Ste 117",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "60563",
            "country_code": "US",
            "telephone_number": "630-687-9595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIZINTOS",
        "first_name": "MEGHANN",
        "middle_name": "REID",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-04",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "85007364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS PA LICENSE",
            "identifier": "85007364",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.