Individual provider Active NPI

Caitlin Anne Weller, PA-C

  • Physician Assistant
  • Arlington Heights, IL
National Provider Identifier
1790112274
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.004830 Issued in IL
Practice address
880 W Central Rd Ste 5000
Arlington Heights, IL 60005-2355
Phone
(847) 618-3800
Fax
(847) 618-3809
NPI assigned
Sep 30, 2013
Last updated
Aug 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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 085.004830 IL Primary

Addresses

Primary practice location

880 W Central Rd Ste 5000
Arlington Heights, IL 60005-2355

Mailing address

2100 Pfingsten Rd
Glenview, IL 60026-1301
Phone (847) 657-5632

Other practice location 1

2100 Pfingsten Rd
Glenview, IL 60026-1301
Phone (847) 657-5632

Other identifiers 1

IdentifierTypeStateIssuer
085004830OtherILSTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cdonahue9235@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
I20131115000123 IL Practitioner - Physician Assistant 0345476669 Reassigns benefits to 3 organizations

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
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1200 W Algonquin Rd
Palatine, IL 60067-7373
Phone (847) 618-0535

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

State licenses

LicenseStateTypeSpecialty
085.004830ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Aug 5, 2015 Accepting new patients
Cep America - Illinois, LLP CurrentSince Oct 1, 2013 Accepting new patients
Northwest Community Health Services Inc Physician Assistant CurrentSince Jun 6, 2022 Accepting new patients
Cepamerica Illinois LLP CurrentSince Oct 1, 2013 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

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

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

800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

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

9532 Eagle Way
Chicago, IL 60678

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

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

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

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

2100 Pfingsten Rd
Glenview, IL 60026
Phone (847) 657-5800

Interoperability endpoints

  • Direct secure messaging: cdonahue9235@direct.nch.org

Organizations & group practices 7

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.

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": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1790112274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 PFINGSTEN RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261301",
            "telephone_number": "847-657-5632",
            "fax_number": "847-657-5993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 W CENTRAL RD STE 5000",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052355",
            "telephone_number": "847-618-3800",
            "fax_number": "847-618-3809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Pfingsten Rd",
            "address_purpose": "LOCATION",
            "city": "Glenview",
            "state": "IL",
            "postal_code": "600261301",
            "country_code": "US",
            "telephone_number": "847-657-5632",
            "fax_number": "847-657-5993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLER",
        "first_name": "CAITLIN",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-30",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.004830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "085004830",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdonahue9235@direct.nch.org",
            "affiliation": "N",
            "address_1": "880 W Central Rd Ste 5000",
            "city": "Arlington Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600052355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.