Individual provider Active NPI

Marina Elyash, PA-C

  • Medical Physician Assistant
  • Chicago, IL
National Provider Identifier
1982800306
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
2901 W Touhy Ave
Chicago, IL 60645-2937
Phone
(773) 973-7350
NPI assigned
Jun 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

2901 W Touhy Ave
Chicago, IL 60645-2937

Mailing address

3537 Paysphere Cir
Chicago, IL 60674-0035
Phone (708) 786-2900

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
I20071005000705 IL Practitioner - Physician Assistant 6608961529 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085-000845ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai Community Foundation Dba Sinia Medical Group CurrentSince Jun 26, 2016 Accepting new patients
Mount Sinai Community Foundation CurrentSince Jun 26, 2016 Accepting new patients
Mount Sinai Community Foundation Past Accepting new patients

Locations

3537 Paysphere Cir
Chicago, IL 60674

2901 W Touhy Ave
Chicago, IL 60645
Phone (773) 973-7350

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

Organizations & group practices 4

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": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982800306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3537 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740035",
            "telephone_number": "708-786-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W TOUHY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606452937",
            "telephone_number": "773-973-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELYASH",
        "first_name": "MARINA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.