Individual provider Active NPI

Shannon Crabtree, PA-C

  • Physician Assistant
  • Warrenville, IL
National Provider Identifier
1750713541
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085004747 Issued in IL
Practice address
4405 Weaver Pkwy
Warrenville, IL 60555-3269
Phone
(630) 352-5450
Fax
(630) 352-5499
NPI assigned
Aug 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085004747 IL Primary

Addresses

Primary practice location

4405 Weaver Pkwy
Warrenville, IL 60555-3269

Mailing address

4405 Weaver Pkwy
Warrenville, IL 60555-3269
Phone (630) 352-5450

Other identifiers 1

IdentifierTypeStateIssuer
085004747OtherILSTATE LICENSE

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
I20131121001622 IL Practitioner - Physician Assistant 6204062201 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
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

4405 Weaver Pkwy
Warrenville, IL 60555-3269
Phone (630) 352-5450

4455 Weaver Pkwy
Warrenville, IL 60555-3269
Phone (630) 821-6400

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Nov 1, 2013 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Nov 1, 2013 Accepting new patients
Northwestern Memorial Physicians Group Past Accepting new patients
Northwestern Memorial Physicians Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

680 N Lake Shore Dr
Ste 818
Chicago, IL 60611

251 E Huron St
#16
Chicago, IL 60611

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

4405 Weaver Pkwy
Warrenville, IL 60555
Phone (630) 352-5450

Organizations & group practices 4

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": "1375401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1750713541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 WEAVER PKWY",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553269",
            "telephone_number": "630-352-5450",
            "fax_number": "630-352-5499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 WEAVER PKWY",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553269",
            "telephone_number": "630-352-5450",
            "fax_number": "630-352-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRABTREE",
        "first_name": "SHANNON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-02",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "085004747",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenville, IL

Sources for this page

Verify at the official NPI Registry.