Individual provider Active NPI

Rhiannon Mazenis, PA-C

  • Physician Assistant
  • Oak Forest, IL
National Provider Identifier
1669563805
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
385001545 Issued in IL
Practice address
5320 159TH St
Suite 400
Oak Forest, IL 60452-4705
Phone
(708) 798-8112
Fax
(708) 535-6396
NPI assigned
Sep 27, 2006
Last updated
Apr 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 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 385001545 IL Primary

Addresses

Primary practice location

5320 159TH St
Suite 400
Oak Forest, IL 60452-4705

Mailing address

1365 Wiley Rd
Ste 153
Schaumburg, IL 60173-4357
Phone (847) 519-4701

Other names 1

  • Rhiannon Sato 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
I20061026000375 IL Practitioner - Physician Assistant 2668479122 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Pain Specialists LLCGroup PAC ID 4082782230, 6 clinicians

Practice addresses (Care Compare)

1365 Wiley Rd
Suite 153
Schaumburg, IL 60173-4357
Phone (847) 519-4701

3800 Highland Ave
Suite 101
Downers Grove, IL 60515-1559
Phone (847) 519-4701

6920 Ogden Ave
Unit C
Berwyn, IL 60402-3685
Phone (847) 519-4701

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
385001545ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Core Orthopedics & Sports Medicine LLC CurrentSince Jan 1, 2025 Accepting new patients
Lawrence County Memorial Hospital Past Accepting new patients

Locations

555 Biesterfield Rd
Elk Grove Vlg, IL 60007
Phone (847) 690-1776

2380 Lakewood Blvd
Hoffman Estates, IL 60192
Phone (847) 690-1776

Interoperability endpoints

  • Direct secure messaging: rhiannon.mazenis.1@9398.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1669563805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 WILEY RD",
            "address_2": "STE 153",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734357",
            "telephone_number": "847-519-4701",
            "fax_number": "847-519-4707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 159TH ST",
            "address_2": "SUITE 400",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604524705",
            "telephone_number": "708-798-8112",
            "fax_number": "708-535-6396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZENIS",
        "first_name": "RHIANNON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "385001545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RHIANNON",
            "last_name": "SATO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oak Forest, IL

Sources for this page

Verify at the official NPI Registry.