Kristen Abbi Fregoso, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085006060 Issued in IL

Practice address

3001 Green Bay Rd
North Chicago, IL 60064-3048

Phone

(814) 713-1825

NPI assigned

Oct 5, 2016

Last updated

Jun 12, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Kristen Abbi Chaffin Former name

Medicare fee-for-service enrollment

Enrolled in NC

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

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 LLCGroup PAC ID 9537468574, 601 clinicians

DLP Western Carolina Physician Practices LLCGroup PAC ID 9032338975, 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 enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• DLP Western Carolina Physician Practices LLC

  • Internal Medicine Physician
  • Sylva, NC
  • NPI 1609281641

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Mission Health Community Multispecialty Providers, LLC

  • Anesthesiology Physician
  • Asheville, NC
  • NPI 1457719130
  Medicare reassignment Care Compare group
• Western North Carolina Community Health Services Inc.

  • Federally Qualified Health Center (FQHC)
  • Asheville, NC
  • NPI 1780801050
  Medicare reassignment
• 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

  Physician Assistant

  NPD
• 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)

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

• DLP Haywood Regional Medical Center LLC.

  dba Haywood Regional Medical Center

  • General Acute Care Hospital
  • Clyde, NC
  • NPI 1811158215
  Care Compare affiliation
• MH Mission Hospital, LLLP

  dba Mission Hospital

  • General Acute Care Hospital
  • Asheville, NC
  • NPI 1962987677
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "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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• Darnell Frye II
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• Mary Furlong

• Medical Physician Assistant in North Chicago, IL
• Providers in North Chicago, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.