Individual provider Active NPI

Aurelia Popp

  • Physician Assistant
  • O Fallon, IL
National Provider Identifier
1912527599
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.009055 Issued in IL
Practice address
1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone
(618) 799-9270
NPI assigned
Apr 23, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 085.009055 IL Primary

Addresses

Primary practice location

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099

Mailing address

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120

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
I20220830001600 IL Practitioner - Physician Assistant 5799190120 Reassigns benefits to 3 organizations

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
Vituity - Illinois Auc LLPGroup PAC ID 0547516932, 35 clinicians

Practice addresses (Care Compare)

1512 N Green Mount Rd
O Fallon, IL 62269-2083
Phone (618) 624-3750

801 W Temple Ave
Effingham, IL 62401-2168
Phone (217) 347-1690

Hospital & facility affiliations

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
085.009055ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Services Midwest SC Physician Assistant CurrentSince Feb 1, 2026 Accepting new patients
Cepamerica Illinois LLP CurrentSince Aug 17, 2022 Accepting new patients
Vituity - Illinois Auc LLP CurrentSince Aug 17, 2022 Accepting new patients
Cepamerica Illinois LLP CurrentSince Aug 17, 2022 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

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

801 W Temple Ave
Effingham, IL 62401
Phone (217) 342-5800

12866 Troxler Ave
Highland, IL 62249
Phone (618) 651-2600

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1912527599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SAINT ELIZABETH BLVD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691099",
            "telephone_number": "618-234-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAINT ELIZABETH BLVD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691099",
            "telephone_number": "618-799-9270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPP",
        "first_name": "AURELIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-23",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.009055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

Verify at the official NPI Registry.