ANNA ELLERBROEK (PA) – Physician Assistant, NPI 1124006010

ANNA ELLERBROEK (PA) is a healthcare provider. based in Machesney park, Illinois. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. The NPI Number for ANNA ELLERBROEK (PA) is 1124006010

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
ANNA ELLERBROEK (PA)
NPI
1124006010
Phone
(815) 654-8000
Address
11475 N 2ND ST
Enumeration Date
3 January 2006
Last Update Date
9 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7737941000
Graduation Year
2005 (21 years ago)
PAC ID
8820018724
Group Practice PAC ID
8729064159
Professional Enrollment ID
I20051206000655
Address ID
IL606411651CH4211XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:20State licenses:0Digital endpointsOther names

5,035 PHYSICIAN ASSISTANT in IL

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Provider Addresses for ANNA ELLERBROEK (PA)

  • North 2nd Street, Machesney Park, Winnebago County, Illinois, 61115, United States

    MACHESNEY PARK, IL 611151285

    Phone: (815) 654-8000

    Fax: (815) 654-8020

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-12-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20051206000655IPhysician AssistantILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes9278$0
99203New patient office or other outpatient visit, 30-44 minutes4747$0
81003Automated urinalysis test2724$0
J7613Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg2711$0
87811Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)2522$0
View full utilization report →

Insurance plans in this area (ZIP 61115)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8729064159View full group profile
NameSpecialtyState
Physician AssistantIL
-IL
-IL
Physician AssistantMI
Physician AssistantIL
-NY
Physician AssistantIL
Nurse PractitionerIL
Physician AssistantMI
Physician AssistantIL

Reviews

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Frequently asked questions

What is the standard ID for ANNA ELLERBROEK (PA) in the U.S.?
In the U.S., ANNA ELLERBROEK (PA) is identified by NPI 1124006010.
Is ANNA ELLERBROEK (PA)'s NPI status active today?
Active status means ANNA ELLERBROEK (PA)'s NPI record is not deactivated in the public file.
Which specialty label fits ANNA ELLERBROEK (PA)?
NPPES ties ANNA ELLERBROEK (PA) to Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to ANNA ELLERBROEK (PA)?
ANNA ELLERBROEK (PA) shows a connection to Machesney Park, Illinois in registry-derived data.
Why is information missing for ANNA ELLERBROEK (PA)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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