Individual provider Active NPI

Caitlin J Engels-Arteaga

  • Medical Physician Assistant
  • Mendota, IL
National Provider Identifier
1790140580
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085005651 Issued in IL
Practice address
1405 E 12TH St
Suite 600
Mendota, IL 61342-9010
Phone
(815) 538-7200
Fax
(815) 539-1444
NPI assigned
Dec 21, 2015
Last updated
Dec 21, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085005651 IL Primary

Addresses

Primary practice location

1405 E 12TH St
Suite 600
Mendota, IL 61342-9010

Mailing address

1405 E 12TH St
Suite 600
Mendota, IL 61342-9010
Phone (815) 538-7200

Other names 1

  • Caitlin J Engels Former name

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
I20160210000062 IL Practitioner - Physician Assistant 1153625298 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mendota Community HospitalGroup PAC ID 2264335777, 51 clinicians
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

1405 E 12TH St
Suite 700
Mendota, IL 61342-9010
Phone (815) 539-2663

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085005651ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mendota Community Hospital CurrentSince Feb 1, 2016 Accepting new patients
Mendota Community Hospital CurrentSince Feb 1, 2016 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Mendota Community Hospital Past Accepting new patients

Locations

1404 Washington St
Mendota, IL 61342
Phone (815) 538-1825

1405 E 12th St
Ste 600
Mendota, IL 61342
Phone (815) 538-7200

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Organizations & group practices 6

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": "1450656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450656000000",
    "number": "1790140580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 E 12TH ST",
            "address_2": "SUITE 600",
            "city": "MENDOTA",
            "state": "IL",
            "postal_code": "613429010",
            "telephone_number": "815-538-7200",
            "fax_number": "815-539-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 E 12TH ST",
            "address_2": "SUITE 600",
            "city": "MENDOTA",
            "state": "IL",
            "postal_code": "613429010",
            "telephone_number": "815-538-7200",
            "fax_number": "815-539-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELS-ARTEAGA",
        "first_name": "CAITLIN",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-21",
        "last_updated": "2015-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085005651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAITLIN",
            "last_name": "ENGELS",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mendota, IL

Sources for this page

Verify at the official NPI Registry.