Active NPI
Ksenia Samvel, PA-C
- Physician Assistant
- Gurnee, IL
National Provider Identifier
1952733818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085.004974
- Practice address
- 1425 N Hunt Club Rd Ste 100
Gurnee, IL 60031-2632 - Phone
- (847) 548-2200
- Fax
- (847) 548-2865
- NPI assigned
- Aug 2, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA08386 | TX | |
| Physician Assistant | 363A00000X | 085.004974 | IL | Primary |
Addresses
Primary practice location
1425 N Hunt Club Rd Ste 100
Gurnee, IL 60031-2632
Mailing address
1425 N Hunt Club Rd Ste 100
Gurnee, IL 60031-2632
Phone (847) 548-2200
Other names 1
- Ksenia Ramos
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ksenia.samvel@phcs.eclinicaldirectplus.com | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1425 Hunt Club Rd
Suite 100
Gurnee, IL 60031-2632
1425 N Hunt Club Rd
Suite 100
Gurnee, IL 60031-2632
Phone (847) 548-2200
525 E Congress Pkwy
Suite 100
Crystal Lake, IL 60014-6271
Phone (626) 327-6795
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.004974 | IL | MD | Physician Assistant |
| PA08386 | TX | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vital Health Partners LLC | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Past | Accepting new patients | |
| Waukegan Clinic Corp | Past | Accepting new patients |
Locations
1324 N Sheridan Rd
Waukegan, IL 60085
Phone (847) 360-3000
Interoperability endpoints
- ksenia.samvel@phcs.eclinicaldirectplus.com
- https://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4
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.
-
- Emergency Medicine Physician
- Crystal Lake, IL
- NPI 1538517198
-
- Family Medicine Physician
- Gurnee, IL
- NPI 1881890333
-
- Emergency Medicine Physician
- Barrington, IL
- NPI 1700810470
-
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
-
- Family Medicine Physician
- Waukegan, IL
- NPI 1306937289
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Libertyville, IL
- NPI 1124272547
-
- Mobile Mammography Clinic/Center
- Grayslake, IL
- NPI 1770737199
Hospital
-
- General Acute Care Hospital
- Barrington, IL
- NPI 1447368071
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710979200000",
"number": "1952733818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1425 N HUNT CLUB RD STE 100",
"city": "GURNEE",
"state": "IL",
"postal_code": "600312632",
"telephone_number": "847-548-2200",
"fax_number": "847-548-2865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 N HUNT CLUB RD STE 100",
"city": "GURNEE",
"state": "IL",
"postal_code": "600312632",
"telephone_number": "847-548-2200",
"fax_number": "847-548-2865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMVEL",
"first_name": "KSENIA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-02",
"last_updated": "2024-03-21",
"certification_date": "2024-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TX",
"license": "PA08386",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085.004974",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ksenia.samvel@phcs.eclinicaldirectplus.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1425 N Hunt Club Rd Ste 100",
"city": "Gurnee",
"state": "IL",
"country_code": "US",
"postal_code": "600312632",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "KSENIA",
"last_name": "RAMOS",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Gurnee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.