FARHANA F UDDIN (P.A.) – Surgical Physician Assistant, NPI 1265613087

FARHANA F UDDIN (P.A.) is a healthcare provider. based in Gurnee, Illinois. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P.A.. They hold a License No. 085001218 (IL). The NPI Number for FARHANA F UDDIN (P.A.) is 1265613087

Main info

Female
29 Years Of Experience
Accepts Medicare Assignment
Name
FARHANA F UDDIN (P.A.)
NPI
1265613087
Phone
(847) 708-8100
Address
1031 CHESWICK DR
Enumeration Date
20 November 2007
Last Update Date
4 May 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3125722000
Graduation Year
1997 (29 years ago)
PAC ID
5294809489
Group Practice PAC ID
2860398088
Professional Enrollment ID
I20080806000406
Address ID
IL606152494CH500XXSTXX400
Telehealth
Yes

Contacts

Secure Messaging
fuddin@direct.ccprovider.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness85
Years active:18State licenses:1Other namesUpdated within 12 months

5,035 PHYSICIAN ASSISTANT in IL

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Provider Addresses for FARHANA F UDDIN (P.A.)

  • 1031, Cheswick Drive, Gurnee, Lake, Illinois, 60031, United States

    GURNEE, IL 600315601

    Phone: (847) 708-8100

    Type: Mailing

  • Fantus Health Center, 1901, West Harrison Street, Near West Side, Illinois Medical District, Chicago, Illinois Medical District, Illinois, 60612, United States

    CHICAGO, IL 606123714

    Phone: (312) 864-5233

    Type: Location

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: 2008-08-06

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
I20080806000406IPhysician 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
99214Established patient office or other outpatient visit, 30-39 minutes4429$0
99213Established patient office or other outpatient visit, 20-29 minutes3626$0
99442Telephone medical discussion with physician, 11-20 minutes1816$0
View full utilization report →

Insurance plans in this area (ZIP 60031)

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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: 2860398088View full group profile
NameSpecialtyState
O P H T H A L M O L O G YIL
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology), Cardiovascular Disease (Cardiology)MA
-IL
-IL
O B S T E T R I C S/ G Y N E C O L O G YIL
-IL
-IL
-IL
A N E S T H E S I O L O G YIL
Physician AssistantIL

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Frequently asked questions

Is FARHANA F UDDIN (P.A.) listed with a National Provider Identifier?
Yes — FARHANA F UDDIN (P.A.) has NPI 1265613087 on file in the registry.
Is FARHANA F UDDIN (P.A.) still an active registrant?
FARHANA F UDDIN (P.A.) carries an active NPI according to the public dataset.
What clinical focus is listed for FARHANA F UDDIN (P.A.)?
At a glance, FARHANA F UDDIN (P.A.) is tied to Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
Is FARHANA F UDDIN (P.A.) associated with Gurnee?
Public fields place FARHANA F UDDIN (P.A.) around Gurnee, Illinois. Always confirm the exact site before visiting.
Can I trust this NPI listing for FARHANA F UDDIN (P.A.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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