Individual provider Active NPI

Sarah Bazzetta, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1679978183
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-005303 Issued in IL
Practice address
259 E Erie St Ste 2400
Chicago, IL 60611-3907
Phone
(312) 695-7269
Fax
(312) 695-4924
NPI assigned
Oct 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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 085-005303 IL Primary

Addresses

Primary practice location

259 E Erie St Ste 2400
Chicago, IL 60611-3907

Mailing address

259 E Erie St Ste 2400
Chicago, IL 60611-3907
Phone (312) 695-7269

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
I20141226000449 IL Practitioner - Physician Assistant 5092038026 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085-005303ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Nov 18, 2022 Accepting new patients
The University of Chicago Medical Center CurrentSince Feb 7, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Nov 18, 2022 Accepting new patients
The University of Chicago Medical Center CurrentSince Feb 7, 2020 Accepting new patients
Central Dupage Physician Group PastSince Jan 1, 2023 Accepting new patients
Lurie Children'S Medical Group, LLC Past Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

Dept 5777
Carol Stream, IL 60122

737 N Michigan Ave
Ste 600
Chicago, IL 60611
Phone (312) 440-3810

259 E Erie St
Ste 2400
Chicago, IL 60611
Phone (312) 694-9676

225 E Chicago Ave
#7
Chicago, IL 60611

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Organizations & group practices 6

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": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1679978183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 2400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113907",
            "telephone_number": "312-695-7269",
            "fax_number": "312-695-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 2400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113907",
            "telephone_number": "312-695-7269",
            "fax_number": "312-695-4924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZZETTA",
        "first_name": "SARAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-27",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-005303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.