Individual provider Active NPI

Brooke Ashley Fenar, PA

  • Physician Assistant
  • Lake in the Hills, IL
National Provider Identifier
1851773386
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5 Turnberry CT
Lake in the Hills, IL 60156-6765
Phone
(630) 329-3898
NPI assigned
Jun 20, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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 Primary

Addresses

Primary practice location

5 Turnberry CT
Lake in the Hills, IL 60156-6765

Mailing address

5 Turnberry CT
Lake in the Hills, IL 60156-6765
Phone (630) 329-3898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210811000129 NC Practitioner - Physician Assistant 1456652817 Reassigns benefits to 4 organizations
I20211004000421 SC Practitioner - Physician Assistant 1456652817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
98.67
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
85.01 of 100Reported as group
Quality
80.14
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.15 of 100Reported as group
Quality
81.36
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4026SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ballantyne Emergency Physicians PLLC CurrentSince Jul 1, 2021 Accepting new patients

Locations

11516 Providence Rd
Charlotte, NC 28277
Phone (704) 667-0370

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: bfenar530345@carolinashealthcaresystem.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1434758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1851773386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 TURNBERRY CT",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601566765",
            "telephone_number": "630-329-3898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 TURNBERRY CT",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601566765",
            "telephone_number": "630-329-3898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENAR",
        "first_name": "BROOKE",
        "middle_name": "ASHLEY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-20",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake in the Hills, IL

Sources for this page

Verify at the official NPI Registry.