Individual provider Active NPI

Rosalva Acosta, PA-C

  • Medical Physician Assistant
  • Gurnee, IL
National Provider Identifier
1972663466
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085-001716 Issued in IL
Practice address
1425 N Hunt Club Rd Ste 100
Gurnee, IL 60031-2632
Phone
(847) 548-2200
Fax
(847) 548-2865
NPI assigned
Dec 12, 2006
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085-001716 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

  • Rosalva Zuniga Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rosalva.acosta@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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141111000170 IL Practitioner - Physician Assistant 3577785328 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085-001716ILMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: rosalva.acosta@phcs.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1972663466",
    "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": "ACOSTA",
        "first_name": "ROSALVA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085-001716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rosalva.acosta@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": "ROSALVA",
            "last_name": "ZUNIGA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gurnee, IL

Sources for this page

Verify at the official NPI Registry.