Alexandra Cessna Farmer, PA-C
Individual provider Active NPI Medical Physician Assistant · Eureka, IL
NPI 1962941419 · NPPES record last updated Feb 23, 2018
Key facts
- NPI
- 1962941419
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 085.006132 (IL)
- Practice address
- 105 S Major St
Eureka, IL 61530-1246 - Phone
- (309) 467-4691
- NPI assigned
- Feb 16, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Obstetrics and Gynecology Care Associates, S.C.
Practice addresses (Care Compare)
1414 Woodbine Rd
Bloomington, IL 61704-2817
Phone 3096622273104
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170328001723 | IL | Practitioner - Physician Assistant | 1456636778 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.006132 | IL | MD | Medical Physician Assistant |
| 085006132 | IL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carle West Physician Group Inc | Current |
Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461
105 S Major St
Eureka, IL 61530
Phone (309) 467-2371
101 S Major St
Eureka, IL 61530
Phone (309) 268-2172
1300 Franklin Ave
Ste 100
Normal, IL 61761
Phone (309) 268-3503
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Interoperability endpoints
- afarmerpa311083@carlehiedirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 085006132 | IL | |
| Medical Physician Assistant | 363AM0700X | 085.006132 | IL | Yes |
Addresses
Primary practice location
105 S Major St
Eureka, IL 61530-1246
Mailing address
105 S Major St
Eureka, IL 61530-1246
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962941419 | Medicaid | IL |
Other providers in Eureka, IL
- Elite Chiropractic Services, LLC
- Eureka Community Hospital
- Eureka Community Hospital
- Eureka Family Dental P.C.
- Eureka Fire Protection District
- Richard Fassola
- Lori Flanary
- Shane C. Fogo
- Todd W. Gander
- GB Accessibility, LLC
All providers in Eureka, IL · Medical Physician Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.