Individual provider Active NPI

Lauren Agostinacchio, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1831779933
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.008177 Issued in IL
Practice address
331 W Surf St Ste 700
Chicago, IL 60657-0083
Phone
(773) 832-7443
Fax
(773) 295-4126
NPI assigned
Apr 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 085.008177 IL Primary

Addresses

Primary practice location

331 W Surf St Ste 700
Chicago, IL 60657-0083

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lagostinacchio@cpderm.emadirect.md

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
I20210802002100 IL Practitioner - Physician Assistant 7911301767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SC 650 clinicians

Practice addresses (Care Compare)

2051 Plainfield Rd
Crest Hill, IL 60403-1865
Phone (815) 741-4343

331 W Surf St
Suite 700
Chicago, IL 60657-0083
Phone (773) 832-7443

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.008177ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. Multi-Specialty CurrentSince Oct 21, 2024 Accepting new patients
Forefront Dermatology, S.C. Multi-Specialty CurrentSince Oct 21, 2024 Accepting new patients
Forefront Dermatology, S.C. Past Accepting new patients

Locations

331 W Surf St
Ste 700
Chicago, IL 60657
Phone (773) 832-7443

2051 Plainfield Rd
Crest Hill, IL 60403
Phone (815) 730-9900

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

Interoperability endpoints

  • Direct secure messaging: lagostinacchio@cpderm.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1831779933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 W SURF ST STE 700",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606570083",
            "telephone_number": "773-832-7443",
            "fax_number": "773-295-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGOSTINACCHIO",
        "first_name": "LAUREN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-12",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.008177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lagostinacchio@cpderm.emadirect.md",
            "affiliation": "N",
            "address_1": "331 W Surf St Ste 700",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606570083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.