Crystal Brozovich, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1802 N Division St Ste 201
Morris, IL 60450-1183

Phone

(815) 513-5625

NPI assigned

Aug 30, 2021

Last updated

Mar 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Crystal Bautista Former name

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Morris HospitalGroup PAC ID 1850372459, 115 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Morris Hospital & Healthcare Centers Hospital, Morris, IL, CCN 140101

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Morris Hospital

  • General Practice Physician
  • Morris, IL
  • NPI 1558466268
  Medicare reassignment Care Compare group NPD
• Morris Hospital

  dba Morris Hospital & Healthcare Centers

  • Health Service Clinic/Center
  • Morris, IL
  • NPI 1376658658
  NPD
• Morris Hospital

  dba Morris Hospital & Healthcare Centers

  • General Practice Physician
  • Channahon, IL
  • NPI 1275648511
  NPD (past)

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

• Morris Hospital

  dba Morris Hospital & Healthcare Centers

  • General Acute Care Hospital
  • Morris, IL
  • NPI 1649370057
  Care Compare affiliation

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1740957455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 SCHOOL ST STE A",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604501207",
            "telephone_number": "815-705-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 N DIVISION ST STE 201",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604501183",
            "telephone_number": "815-513-5625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1320 W Lombard St",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "IA",
            "postal_code": "528042029",
            "country_code": "US",
            "telephone_number": "815-630-1728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROZOVICH",
        "first_name": "CRYSTAL",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "BAUTISTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Bolden Jr., M.D.
• Bradley R. Lawton, M.D., P.C.
• Brenene Marie Brady, M.S. CCC-A
• Jessica Brelje, MPT
• Miranda Brennan
• Jennifer Brumfield, FNP
• Amy Kathryn Brummel
• Laura Bruyn
• Gail Buehl, OTA
• Allison Christine Buldak, PHARMD

• Physician Assistant in Morris, IL
• Providers in Morris, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.