Individual provider Active NPI

Abigail Grover, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1639804172
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.009047 Issued in IL
Practice address
1203 W Augusta Blvd Ste 1
Chicago, IL 60642-4327
Phone
(773) 248-2255
NPI assigned
Jul 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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 085.009047 IL Primary

Addresses

Primary practice location

1203 W Augusta Blvd Ste 1
Chicago, IL 60642-4327

Mailing address

1203 W Augusta Blvd Ste 1
Chicago, IL 60642-4327
Phone (773) 248-2255

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
I20220831000427 IL Practitioner - Physician Assistant 0143604710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bespoke PsychiatryGroup PAC ID 3274951744, 51 clinicians

Practice addresses (Care Compare)

1203 W Augusta Blvd
Chicago, IL 60642-4327
Phone (773) 248-2255

Merit-based Incentive Payment System (MIPS)

Final score
97.25 of 100Reported as group
Quality
80.59
Promoting interoperability
100
Improvement activities
40
Cost
76.91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.009047ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bespoke Psychiatry CurrentSince Aug 1, 2022 Accepting new patients

Locations

1203 W Augusta Blvd
Ste 1
Chicago, IL 60642
Phone (773) 248-2255

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": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1639804172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 W AUGUSTA BLVD STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606424327",
            "telephone_number": "773-248-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 W AUGUSTA BLVD STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606424327",
            "telephone_number": "773-248-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVER",
        "first_name": "ABIGAIL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-19",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.009047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.