Individual provider Active NPI

Benjamin J. Sigwarth, PA-C

  • Medical Physician Assistant
  • Berwyn, IL
National Provider Identifier
1871784405
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085-002995 Issued in IL
Practice address
3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone
(708) 783-6000
NPI assigned
Aug 8, 2007
Last updated
Dec 2, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10001062A IN
Medical Physician Assistant 363AM0700X 085-002995 IL Primary

Addresses

Primary practice location

3249 Oak Park Ave
Berwyn, IL 60402-3429

Mailing address

3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone (708) 783-6000

Other identifiers 1

IdentifierTypeStateIssuer
000000616964OtherINANTHEM PROVIDER NUMBER

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
I20070822001235 IL Practitioner - Physician Assistant 8325130354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.41 of 100Reported as group
Quality
86.81
Improvement activities
40
Cost
77.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10001062AINMDPhysician Assistant
085-002995ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cepamerica Illinois LLP CurrentSince Jun 1, 2013 Accepting new patients
Cepamerica Illinois LLP CurrentSince Jun 1, 2013 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

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

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449014400000",
    "number": "1871784405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3249 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023429",
            "telephone_number": "708-783-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3249 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023429",
            "telephone_number": "708-783-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIGWARTH",
        "first_name": "BENJAMIN",
        "middle_name": "J.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2015-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001062A",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085-002995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000616964",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.