Individual provider Active NPI

Kristen Frogner, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1962229351
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085010594 Issued in IL
Practice address
1957 N Fairfield Ave Apt 1F
Chicago, IL 60647-2359
Phone
(248) 719-9071
NPI assigned
Sep 25, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 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 085010594 IL Primary

Addresses

Primary practice location

1957 N Fairfield Ave Apt 1F
Chicago, IL 60647-2359

Mailing address

1957 N Fairfield Ave Apt 1F
Chicago, IL 60647-2359
Phone (248) 719-9071

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
I20241213002684 IL Practitioner - Physician Assistant 7416483409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clarity Clinic LLCGroup PAC ID 7517284755, 110 clinicians

Practice addresses (Care Compare)

1 E Superior St
Suite 306
Chicago, IL 60611-2595
Phone (312) 754-9404

333 N Michigan Ave
Suite 1400
Chicago, IL 60601-4011
Phone (312) 815-9660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085010594ILMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1727222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1962229351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1957 N FAIRFIELD AVE APT 1F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472359",
            "telephone_number": "248-719-9071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1957 N FAIRFIELD AVE APT 1F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472359",
            "telephone_number": "248-719-9071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FROGNER",
        "first_name": "KRISTEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085010594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.