Individual provider Active NPI

Stacy P Snyder, PA-C

  • Surgical Physician Assistant
  • Chicago, IL
National Provider Identifier
1740619113
Registry record updated Apr 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085004788 Issued in IL
Practice address
3000 N Halsted St
Ste 525
Chicago, IL 60657-5188
Phone
(773) 433-3130
NPI assigned
Nov 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 085004788 IL Primary

Addresses

Primary practice location

3000 N Halsted St
Ste 525
Chicago, IL 60657-5188

Mailing address

3000 N Halsted St
Ste 525
Chicago, IL 60657-5188
Phone (773) 433-3130

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
I20140306001726 IL Practitioner - Physician Assistant 2264662568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Bone and Joint Institute, LLCGroup PAC ID 6002814878, 603 clinicians

Practice addresses (Care Compare)

2101 Waukegan Rd
Bannockburn, IL 60015-1836

2845 N Sheridan Rd
Suite 6400
Chicago, IL 60657-7227
Phone (773) 777-9900

Merit-based Incentive Payment System (MIPS)

Final score
81.07 of 100Reported as group
Quality
76.54
Promoting interoperability
83
Improvement activities
40
Cost
74.52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085004788ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Bone and Joint Institute LLC CurrentSince Jan 1, 2020 Accepting new patients
Illinois Bone and Joint Institute, LLC CurrentSince Jan 1, 2020 Accepting new patients

Locations

2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096

331 W Surf St
Ste 6400
Chicago, IL 60657
Phone (773) 433-3130

3000 N Halsted St
Ste 525
Chicago, IL 60657
Phone (773) 433-3130

2845 N Sheridan Rd
Ste 6400
Chicago, IL 60657
Phone (312) 332-2226

5057 Paysphere Cir
Chicago, IL 60674

900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090

Organizations & group practices 2

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": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1740619113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N HALSTED ST",
            "address_2": "STE 525",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575188",
            "telephone_number": "773-433-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N HALSTED ST",
            "address_2": "STE 525",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575188",
            "telephone_number": "773-433-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "STACY",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-06",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085004788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.