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DIESAWIT T HANSOM FNP
NPI 1689391633
Nurse Practitioner - Family in Libertyville, IL

Active since October 20, 2022PECOS EnrolledAccepts Medicare Assignment
1366 S MILWAUKEE AVE, LIBERTYVILLE, IL 60048(847) 236-0323 Get Directions Write a Review

NPPES record last updated: June 12, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 12, 2025, Dec 14, 2022, Nov 29, 2022 and 1 more (4 updates tracked since 2022).

About Diesawit T Hansom Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DIESAWIT T HANSOM FNP (NPI 1689391633) is an individual family provider in Libertyville, Illinois, licensed in Illinois (277.004265) and active in the NPI registry since October 2022. She is enrolled in Medicare PECOS, is affiliated with Northwestern Medicine Central Dupage Hospital, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1689391633
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameDIESAWIT T HANSOMCredential: FNP
Location Address1366 S MILWAUKEE AVELibertyville, IL 60048-3795
Mailing Address1366 S Milwaukee AveLibertyville, IL 60048-3795 · (847) 236-0323
Phone(847) 236-0323
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateOctober 20, 2022
Last NPPES UpdateJune 12, 20254 updates tracked since enumeration
NPPES CertifiedJune 12, 2025
✔ NPI 1689391633 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 277.004265
1366 S MILWAUKEE AVE, Libertyville, IL 60048
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare), Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Diesawit T Hansom Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820462849
PECOS Enrollment IDI20230314002620
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show Diesawit Hansom reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Your Healthcare Source PLLC
2.6 mi
Urgent Care
1366 S MILWAUKEE AVE
Libertyville, IL 60048
  • Reassigned Medicare billing, Illinois enrollment
  • 5 clinicians in this Medicare group
NPI 1811740046 (847) 236-0323
Lake County Immediate Care, LLC
7.0 mi
Urgent Care
724 N GREEN BAY RD
Waukegan, IL 60085
  • Reassigned Medicare billing, Illinois enrollment
  • 13 clinicians in this Medicare group
NPI 1285048975 (312) 753-5167
Midwest Express Care 2, Inc
35 mi
Urgent Care
40 75TH ST
Willowbrook, IL 60527
  • Reassigned Medicare billing, Illinois enrollment
  • 410 clinicians in this Medicare group
NPI 1548692890 (630) 400-4060
Signify Health Medical Associates, PLLC
807 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Illinois enrollment
  • 712 clinicians in this Medicare group
NPI 1750845863 (972) 715-3800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
13 services13 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
13 services13 patients
Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) 87811
This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.
12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northwestern Medicine Central Dupage Hospital

Acute Care Hospitals · Winfield, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140242
Location25 North Winfield RoadWinfield, IL 60190 · Du Page County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60048 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$93.02 typical visit price
range $59.81 – $181.38
Typical copayment $23.25 (range $14.95 – $45.34)
Most-billed visit code 99203
Established Patient
$105.07 typical visit price
range $19.15 – $147.12
Typical copayment $26.26 (range $4.78 – $36.78)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ARMENAK ASATRYAN M.D.
Internal Medicine
1366 S MILWAUKEE AVE
LIBERTYVILLE, IL 60048
Lake County (847) 236-0323
YOUR HEALTHCARE SOURCE PLLC
Clinic/Center (Urgent Care)
1366 S MILWAUKEE AVE
LIBERTYVILLE, IL 60048
Lake County (847) 236-0323

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Diesawit Hansom's NPI number?

The NPI number for Diesawit Hansom is 1689391633. It was assigned to this individual provider in the NPPES registry on October 20, 2022.

Where is Diesawit Hansom located?

Diesawit Hansom practices at 1366 S Milwaukee Ave, Libertyville, IL 60048. The listed phone number is (847) 236-0323.

What is Diesawit Hansom's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Diesawit Hansom enrolled in Medicare?

Yes. Diesawit Hansom is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Diesawit Hansom's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Diesawit Hansom reassigns Medicare benefits to 4 organizations: Your Healthcare Source PLLC (Libertyville, IL), Lake County Immediate Care, LLC (Waukegan, IL), Midwest Express Care 2, Inc (Willowbrook, IL) and Signify Health Medical Associates, PLLC (Dallas, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Diesawit Hansom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Diesawit Hansom accept?

Health plans from CareSource (Common Ground Healthcare) and Oscar Health list Diesawit Hansom as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Diesawit Hansom affiliated with any hospitals?

According to CMS data, Diesawit Hansom is affiliated with Northwestern Medicine Central Dupage Hospital.

When was this NPI record last updated?

The NPPES record for Diesawit Hansom was last updated on June 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.