OJHANAE STALLWORTH
NPI 1710661053
Physician Assistant - Surgical in Evanston, IL

Q: What is Ojhanae Stallworth's NPI number?

The NPI number for Ojhanae Stallworth is 1710661053. It was assigned to this individual provider in the NPPES registry on June 14, 2023.

Q: What is Ojhanae Stallworth's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Active since June 14, 2023PECOS EnrolledAccepts Medicare Assignment

2650 RIDGE AVE STE 1223, EVANSTON, IL 60201(847) 570-2040(847) 733-5315 Get Directions Write a Review

NPPES record last updated: March 12, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Mar 12, 2026, Jun 14, 2023 (2 updates tracked since 2023).

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About Ojhanae Stallworth NPPES

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

OJHANAE STALLWORTH (NPI 1710661053) is an individual surgical provider in Evanston, Illinois, licensed in Illinois (085010207) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS, is affiliated with Northshore University Healthsystem - Evanston Hospital, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1710661053

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameOJHANAE STALLWORTH

Location Address2650 RIDGE AVE STE 1223Evanston, IL 60201-1700

Mailing Address9600 Gross Point RdSkokie, IL 60076-1214 · (847) 677-9600 · Fax (847) 933-6036

Phone(847) 570-2040

Fax(847) 733-5315

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateJune 14, 2023

Last NPPES UpdateMarch 12, 20262 updates tracked since enumeration

NPPES CertifiedMarch 12, 2026

✔ NPI 1710661053 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in IL · 085010207

Also ListedPhysician AssistantTaxonomy 363A00000X · License 085010207 (IL)

2650 RIDGE AVE STE 1223, Evanston, IL 60201

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ojhanae Stallworth 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 ID5698115277

PECOS Enrollment IDI20240430001334

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.

Hospital Affiliations CMS Care Compare

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

Northshore University Healthsystem - Evanston Hospital

Acute Care Hospitals · Evanston, IL

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140010

Location2650 Ridge AveEvanston, IL 60201 · Cook County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

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

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