Kristyn Marie Fara, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085004542 Issued in IL

Practice address

1051 W Rand Rd Ste 110
Arlington Heights, IL 60004-2315

Phone

(847) 618-9292

Fax

(847) 618-9294

NPI assigned

Jan 28, 2013

Last updated

Mar 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Kristyn Marie Genrich Former name

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252

Merit-based Incentive Payment System (MIPS)

Final score

84.9 of 100Reported as group

Quality

75.91

Promoting interoperability

99

Improvement activities

40

Cost

74.6

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882
  Medicare reassignment Care Compare group
• Northwest Community Health Services Inc

  dba NCH Medical Group

  • Internal Medicine Physician
  • Arlington Heights, IL
  • NPI 1134433154
  Medicare reassignment
• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD
• Northwest Community Health Services Inc

  dba NCH Medical Group

  • Obstetrics Physician
  • Arlington Heights, IL
  • NPI 1467057513

  Physician Assistant

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northwest Community Hospital

  dba Endeavor Health Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1578932869
  Care Compare affiliation
• Northwest Community Hospital

  dba Endeavor Health Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1770531600
  Care Compare affiliation

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

{
    "created_epoch": "1359331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1962740852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 W RAND RD STE 110",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600042315",
            "telephone_number": "847-618-9292",
            "fax_number": "847-618-9294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 W RAND RD STE 110",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600042315",
            "telephone_number": "847-618-9292",
            "fax_number": "847-618-9294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 S McHenry Rd",
            "address_purpose": "LOCATION",
            "city": "Buffalo Grove",
            "state": "IL",
            "postal_code": "600896705",
            "country_code": "US",
            "telephone_number": "847-618-0351",
            "fax_number": "847-618-0762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARA",
        "first_name": "KRISTYN",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-28",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "385003266",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085004542",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgenrich16146@direct.nch.org",
            "affiliation": "N",
            "address_1": "1051 W Rand Rd Ste 110",
            "city": "Arlington Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600042315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTYN",
            "last_name": "GENRICH",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.

Verify at the official NPI Registry.