Individual provider Active NPI

Katie K Weiner, PA-C

  • Surgical Physician Assistant
  • Arlington Heights, IL
National Provider Identifier
1750612297
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085003686 Issued in IL
Practice address
880 W Central Rd
Suite 3800
Arlington Heights, IL 60005-2369
Phone
(847) 483-9800
Fax
(847) 483-9808
NPI assigned
Jan 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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 085003686 IL Primary

Addresses

Primary practice location

880 W Central Rd
Suite 3800
Arlington Heights, IL 60005-2369

Mailing address

880W Central Rd 5000
Arlington Heights, IL 60005-2355
Phone (847) 618-3800

Other identifiers 1

IdentifierTypeStateIssuer
085003686OtherILSTATE LICENSE

Other names 1

  • Katie Ann Kopin Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kweiner17014@direct.nch.org

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
I20100311000796 IL Practitioner - Physician Assistant 2668507971 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

800 W Central Rd
Arlington Heights, IL 60005-2349
Phone (847) 618-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Community Health Services Inc CurrentSince Jan 1, 2014 Accepting new patients
Endeavor Health Medical Group CurrentSince Nov 30, 2023 Accepting new patients
Northwest Community Health Services Inc Past Accepting new patients
NCH Service Company LLC Past Accepting new patients

Locations

880 W Central Rd
Ste 5000
Arlington Heights, IL 60005
Phone (847) 618-3800

880 W Central Rd
Ste 3800
Arlington Hts, IL 60005
Phone (847) 255-0900

880 W Central Rd
Arlington Hts, IL 60005
Phone (847) 394-3553

880 W Central Rd
Ste 4400
Arlington Hts, IL 60005
Phone (847) 433-0800

1051 W Rand Rd
Arlington Hts, IL 60004
Phone (847) 221-4601

1450 Busch Pkwy
Buffalo Grove, IL 60089
Phone (847) 459-7860

9532 Eagle Way
Chicago, IL 60678

800 Biesterfield Rd
Ste 304
Elk Grove Village, IL 60007
Phone (847) 439-1005

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

Interoperability endpoints

  • Direct secure messaging: kweiner17014@direct.nch.org

Organizations & group practices 5

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 2

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": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1750612297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880W CENTRAL RD 5000",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052355",
            "telephone_number": "847-618-3800",
            "fax_number": "847-618-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 W CENTRAL RD",
            "address_2": "SUITE 3800",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052369",
            "telephone_number": "847-483-9800",
            "fax_number": "847-483-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINER",
        "first_name": "KATIE",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-22",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085003686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "085003686",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kweiner17014@direct.nch.org",
            "affiliation": "N",
            "address_1": "880 W Central Rd",
            "address_2": "Suite 3800",
            "city": "Arlington Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600052369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "KOPIN",
            "middle_name": "ANN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.