Individual provider Active NPI

Fiona Peterman, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1851812291
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085006263 Issued in IL
Practice address
675 N Saint Clair St Ste 15-200
Chicago, IL 60611-5967
Phone
(312) 695-8182
Fax
(312) 695-4303
NPI assigned
Jul 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 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 085006263 IL Primary

Addresses

Primary practice location

675 N Saint Clair St Ste 15-200
Chicago, IL 60611-5967

Mailing address

675 N Saint Clair St Ste 15-200
Chicago, IL 60611-5967
Phone (312) 695-8182

Other names 1

  • Fiona D'Agostino Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085006263ILMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1851812291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 15-200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115967",
            "telephone_number": "312-695-8182",
            "fax_number": "312-695-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 15-200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115967",
            "telephone_number": "312-695-8182",
            "fax_number": "312-695-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERMAN",
        "first_name": "FIONA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-06",
        "last_updated": "2022-10-25",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FIONA",
            "last_name": "D'AGOSTINO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.