Individual provider Active NPI

Ashtyn Charlene Stang, PA-C

  • Surgical Physician Assistant
  • Arlington Heights, IL
National Provider Identifier
1700288990
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085.005501 Issued in IL
Practice address
880 W Central Rd Ste 4100
Arlington Heights, IL 60005-2383
Phone
(847) 618-4400
Fax
(847) 618-4409
NPI assigned
Sep 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA057179 PA
Surgical Physician Assistant 363AS0400X 085.005501 IL Primary

Addresses

Primary practice location

880 W Central Rd Ste 4100
Arlington Heights, IL 60005-2383

Mailing address

880 W Central Rd Ste 4100
Arlington Heights, IL 60005-2383
Phone (847) 618-4400

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
I20150827002744 IL Practitioner - Physician Assistant 7517273162 Reassigns benefits to 1 organization

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
Bonaventure Medical Foundation LLCGroup PAC ID 7517863178, 164 clinicians

Practice addresses (Care Compare)

1555 Barrington Rd
Hoffman Estates, IL 60169-1019
Phone (847) 490-6945

1555 N Barrington Rd
BLDG 1 Suite 505
Hoffman Estates, IL 60169-1099
Phone (847) 490-6960

1786 Moon Lake Blvd
Hoffman Est, IL 60194-5029
Phone (847) 755-8208

800 Biesterfield Rd
Elk Grove Village, IL 60007-3361

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA057179PAMDPhysician Assistant
085.005501ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vireo Emergency Physicians LLC Past Accepting new patients
Chicago Gastro LLC Past Accepting new patients

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 and National Provider Directory roles.

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": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1700288990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 W CENTRAL RD STE 4100",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052383",
            "telephone_number": "847-618-4400",
            "fax_number": "847-618-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 W CENTRAL RD STE 4100",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052383",
            "telephone_number": "847-618-4400",
            "fax_number": "847-618-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANG",
        "first_name": "ASHTYN",
        "middle_name": "CHARLENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA057179",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085.005501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.