Kristen L Dolder, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085004109 Issued in IL

Practice address

1340 Ryan Pkwy
Algonquin, IL 60102-4527

Phone

(815) 276-0150

Fax

(877) 461-6742

NPI assigned

Nov 23, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CIHEBA

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.

• Shah Medical Associates LLC

  • Internal Medicine Physician
  • Sycamore, IL
  • NPI 1609821008
  Medicare reassignment
• Sycamore Medical Associates LLC

  • Family Medicine Physician
  • Sycamore, IL
  • NPI 1770916777
  Medicare reassignment
• Northwest Pulmonary and Sleep Medicine SC

  • Legal Medicine
  • Algonquin, IL
  • NPI 1881878221
  NPD

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1992072649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 RYAN PKWY",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601024527",
            "telephone_number": "815-276-0150",
            "fax_number": "877-461-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 RYAN PKWY",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601024527",
            "telephone_number": "815-276-0150",
            "fax_number": "877-461-6742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1750 N Randall Rd",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601237900",
            "country_code": "US",
            "telephone_number": "224-629-4525",
            "fax_number": "224-629-4527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOLDER",
        "first_name": "KRISTEN",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-23",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "085004109",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dr Scotts Chiropractic Services PC
• Craig Duncan, DDS
• Casey Jean Duval, ATC, LAT

• Physician Assistant in Algonquin, IL
• Providers in Algonquin, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.