Audrey L Mascitti

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

277003370 Issued in IL

Practice address

266 Blazing Star Dr
Minooka, IL 60447-8433

Phone

(708) 966-9465

Fax

(708) 866-2038

NPI assigned

May 9, 2019

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

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

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paragon Clinical LLCGroup PAC ID 7214034925, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Paragon Clinical LLC

  • Nurse Practitioner
  • Burr Ridge, IL
  • NPI 1114139946

  IL, Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Connections Medical Group Associates LLC

  • Child & Adolescent Psychiatry Physician
  • New Lenox, IL
  • NPI 1548697618
  NPD
• Paragon Clinical Midwest, LLC

  • Nurse Practitioner
  • Merrillville, IN
  • NPI 1619335700
  NPD (past)

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1669037206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "266 BLAZING STAR DR",
            "city": "MINOOKA",
            "state": "IL",
            "postal_code": "604478433",
            "telephone_number": "708-966-9465",
            "fax_number": "708-866-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 BLAZING STAR DR",
            "city": "MINOOKA",
            "state": "IL",
            "postal_code": "604478433",
            "telephone_number": "708-966-9465",
            "fax_number": "708-866-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASCITTI",
        "first_name": "AUDREY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-09",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277003370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liberty Medical Center of Minooka, SC
• Jessica Magana
• Shital Manek, PHARM D
• Shelley A Manning
• Joann Lynn Maruszak, D.C.
• Carrie E McCarthy, M.S. CCC-SLP/L
• Amanda McCleary
• James Dale McGehee, DDS
• Aileen McKenna-Burke, LCSW
• Erin Meyerhoff, PT

• All providers in Minooka, IL
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.