Individual provider Active NPI

Brianna Gabrielle Fiala, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1962141457
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085010468 Issued in IL
Practice address
676 N Saint Clair St Ste 650
Chicago, IL 60611-2929
Phone
(312) 695-4835
Fax
(312) 695-3644
NPI assigned
Jun 2, 2022
Last updated
Sep 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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 085010468 IL Primary

Addresses

Primary practice location

676 N Saint Clair St Ste 650
Chicago, IL 60611-2929

Mailing address

676 N Saint Clair St Ste 650
Chicago, IL 60611-2929
Phone (312) 695-4835

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
I20240802002738 IL Practitioner - Physician Assistant 4981141397 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Northwestern University Feinberg Medical School, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

250 E Superior
2304 Nwmff Prent WMN Hosp
Chicago, IL 60611-2914
Phone (312) 472-3660

250 E Superior St
Chicago, IL 60611-2914

251 E Huron
Chicago, IL 60611-2908

251 E Huron St
Chicago, IL 60611-2908

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jul 23, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 23, 2024 Accepting new patients
Trivedimd LLC CurrentSince Mar 12, 2023 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

1605 S Michigan Ave
Chicago, IL 60616
Phone (312) 212-1404

1605 S Michigan Ave
Ste B
Chicago, IL 60616
Phone (312) 535-5770

1605 S Michigan Ave
Unit 1
Chicago, IL 60616
Phone (312) 535-5770

259 E Erie St
Ste 1600
Chicago, IL 60611

676 N Saint Clair St
Ste 650
Chicago, IL 60611
Phone (312) 695-3800

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Interoperability endpoints

  • Direct secure messaging: brianna.fiala.1@22028.direct.athenahealth.com
  • Direct secure messaging: brianna.fiala.1@3342.direct.athenahealth.com

Organizations & group practices 5

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.

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": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1962141457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 650",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112929",
            "telephone_number": "312-695-4835",
            "fax_number": "312-695-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 650",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112929",
            "telephone_number": "312-695-4835",
            "fax_number": "312-695-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIALA",
        "first_name": "BRIANNA",
        "middle_name": "GABRIELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-02",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085010468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.