SANDRA JEAN MICCI (PA-C) – Physician Assistant, NPI 1942223334
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
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Provider Addresses for SANDRA JEAN MICCI (PA-C)
Fantus Health Center, 1901, West Harrison Street, Near West Side, Illinois Medical District, Chicago, Illinois Medical District, Illinois, 60612, United States
JOHN H STROGER HOSPITAL/ CORE CENTER
CHICAGO, IL 606123714
Phone: (312) 572-4570
Fax: (312) 572-4559
Type: Location
101, Helm Road, Barrington Hills, Barrington Township, Cook County, Illinois, 60010, United States
BARRINGTON, IL 600107645
Phone: (847) 551-3518
Fax: (312) 572-4559
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $240.
Total Amount is formed as General ($240) + Research ($0) + Ownership ($0) = $240.
Last reported payment date: 2024-12-04 • Largest payer in this snapshot: ViiV Healthcare Company ($122).
Total Amount
$240
General + Research + Ownership
Payments
2
Total payment records
General Amount
$240
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ViiV Healthcare Company | $122 |
| Gilead Sciences, Inc. | $119 |
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: 2006-10-31
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20061031000011 | I | Physician Assistant | IL | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60612)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O P H T H A L M O L O G Y | IL | |
| 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 Y | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| A N E S T H E S I O L O G Y | IL | |
| Physician Assistant | IL |
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