Individual provider Active NPI

Alex K Joseph, MBBS, PA-C

  • Physician Assistant
  • St Charles, IL
National Provider Identifier
1669923280
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085005999 Issued in IL
Practice address
2000 W Main St
St Charles, IL 60174-1775
Phone
(630) 463-6036
NPI assigned
Oct 19, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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 085005999 IL Primary

Addresses

Primary practice location

2000 W Main St
St Charles, IL 60174-1775

Mailing address

9403 Clancy Dr
Des Plaines, IL 60016-5118
Phone (224) 399-5393

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
I20170607002921 IL Practitioner - Physician Assistant 7719255140 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Wisconsin School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cermak Medical Group LLCGroup PAC ID 7113269242, 21 clinicians

Practice addresses (Care Compare)

1669 Algonquin Rd
Rolling Meadows, IL 60008-4290
Phone (847) 258-4500

2380 S Elmhurst Rd
Mt Prospect, IL 60056-5805
Phone (708) 222-0100

5741 W Cermak Rd
Cicero, IL 60804-2129
Phone (708) 222-0100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085005999ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ownmed Medical Group PLLC Current Accepting new patients

Organizations & group practices 5

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": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1669923280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9403 CLANCY DR",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600165118",
            "telephone_number": "224-399-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W MAIN ST",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741775",
            "telephone_number": "630-463-6036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "ALEX",
        "middle_name": "K",
        "credential": "MBBS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-19",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

Verify at the official NPI Registry.