Kristen Abbi Fregoso, PA-C

Key facts

NPI

1730639451

Entity type

Individual (NPI type 1)

Primary specialty

Medical Physician Assistant 363AM0700X

License

085006060 (IL)

Practice address

3001 Green Bay Rd
North Chicago, IL 60064-3048

Phone

(814) 713-1825

NPI assigned

Oct 5, 2016

Sex

Female

Sole proprietor

No

Organizations & group practices 12

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.

• DLP Western Carolina Physician Practices LLC Internal Medicine Physician · Sylva, NC · NPI 1609281641
  Medicare reassignment Care Compare group NC
• Mission Health Community Multispecialty Providers, LLC Anesthesiology Physician · Asheville, NC · NPI 1457719130
  Medicare reassignment Care Compare group NC
• DLP Western Carolina Physician Practices LLC Diagnostic Radiology Physician · Clyde, NC · NPI 1932925062
  Care Compare group NPD
• Western North Carolina Community Health Services Inc. Federally Qualified Health Center (FQHC) · Asheville, NC · NPI 1780801050
  Medicare reassignment NC
• DLP Western Carolina Physician Practices LLC Rural Health Clinic/Center · Sylva, NC · NPI 1003687187
  Care Compare group
• DLP Western Carolina Physician Practices LLC Rural Health Clinic/Center · Sylva, NC · NPI 1316718497
  Care Compare group
• Mission Community Anesthesiology Specialists LLC Certified Respiratory Therapist · Asheville, NC · NPI 1528538766
  NPD
• Mission Community Anesthesiology Specialists LLC Cardiovascular Disease Physician · Asheville, NC · NPI 1538639976
  NPD PHYSICIAN ASSISTANT
• Western North Carolina Community Health Services, Inc. Community Health Clinic/Center · Asheville, NC · NPI 1043392921
  NPD
• Western North Carolina Community Health Services, Inc. Federally Qualified Health Center (FQHC) · Marion, NC · NPI 1790402345
  NPD
• Haywood Women'S Medical Center, PA Obstetrics & Gynecology Physician · Clyde, NC · NPI 1578549192
  NPD (past)
• Mission Community Anesthesiology Specialists LLC Clinical Social Worker · Asheville, NC · NPI 1235609538
  NPD (past)

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• DLP Haywood Regional Medical Center LLC. General Acute Care Hospital · Clyde, NC · NPI 1811158215
  Care Compare affiliation Hospital
• MH Mission Hospital, LLLP General Acute Care Hospital · Asheville, NC · NPI 1962987677
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Physician Assistant

Education

Duke University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mission Health Community Multispecialty Providers LLC (601 clinicians)
DLP Western Carolina Physician Practices LLC (177 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Mission Hospital and Asheville Surgery Ce Hospital · Asheville, NC · CCN 340002
• Haywood Regional Medical Center Hospital · Clyde, NC · CCN 340184

Medicare participation

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristen.fregoso.1@9865.direct.athenahealth.com

Specialties & licenses

Addresses

Other names

• Ms. Kristen Abbi Chaffin Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 12, 2019.

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1730639451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 GREEN BAY ROAD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "60064",
            "telephone_number": "847-688-6755",
            "fax_number": "847-688-2751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 GREEN BAY RD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643048",
            "telephone_number": "814-713-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREGOSO",
        "first_name": "KRISTEN",
        "middle_name": "ABBI",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-05",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085006060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "CHAFFIN",
            "middle_name": "ABBI",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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All providers in North Chicago, IL · Medical Physician Assistant in Illinois