NPIMap

Individual provider Active NPI

Rebecca Sue Maczko, PA

  • Physician Assistant
  • Warrenville, IL
National Provider Identifier
1942457734
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-003248 Issued in IL
Practice address
27650 Ferry Rd
Warrenville, IL 60555-3845
Phone
(630) 225-2345
Fax
(630) 225-2399
NPI assigned
Aug 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 085-003248 IL
Physician Assistant 363A00000X 085-003248 IL Primary

Addresses

Primary practice location

27650 Ferry Rd
Warrenville, IL 60555-3845

Mailing address

27650 Ferry Rd
Warrenville, IL 60555-3845
Phone (630) 225-2345

Other identifiers 1

IdentifierTypeStateIssuer
P01279235OtherILRR MEDICARE

Other names 1

  • Ms. Rebecca Sue Warner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080905000623 IL Practitioner - Physician Assistant 1254407703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

233 S Gary Ave
Bloomingdale, IL 60108-2213
Phone (630) 208-6775

25 N Winfield Rd
Winfield, IL 60190-1295

27650 Ferry Rd
Warrenville, IL 60555-3845
Phone (630) 225-2663

300 Randall Rd
Geneva, IL 60134-4200
Phone (630) 933-4700

304 Randall Rd
Geneva, IL 60134-4200
Phone (630) 307-7799

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085-003248ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Mar 4, 2013 Accepting new patients

Locations

636 Raymond Dr
Ste 200
Naperville, IL 60563
Phone (630) 355-5302

27650 Ferry Rd
Warrenville, IL 60555
Phone (630) 225-2345

27650 Ferry Rd
Ste 100
Warrenville, IL 60555
Phone (630) 225-2455

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 2

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 4

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": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1942457734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27650 FERRY RD",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553845",
            "telephone_number": "630-225-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27650 FERRY RD",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553845",
            "telephone_number": "630-225-2345",
            "fax_number": "630-225-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACZKO",
        "first_name": "REBECCA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-22",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085-003248",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-003248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01279235",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "WARNER",
            "middle_name": "SUE",
            "prefix": "MS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Warrenville, IL

Sources for this page

Verify at the official NPI Registry.