SOPHIA HOPE KANNENBERG O' BRYAN PA-C
NPI 1801379383
Physician Assistant in Libertyville, IL

Q: What is Sophia O' Bryan's NPI number?

The NPI number for Sophia O' Bryan is 1801379383. It was assigned to this individual provider in the NPPES registry on September 11, 2018.

Q: What is Sophia O' Bryan's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Sophia O' Bryan was last updated on August 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.

Active since September 11, 2018PECOS EnrolledAccepts Medicare Assignment

93.08/100

CMS Quality Rating

720 FLORSHEIM DR, LIBERTYVILLE, IL 60048(847) 247-4000(847) 234-2090 Get Directions Write a Review

NPPES record last updated: August 2, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Sophia Hope Kannenberg O' Bryan Pa-c NPPES

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

SOPHIA HOPE KANNENBERG O' BRYAN PA-C (NPI 1801379383) is an individual physician assistant in Libertyville, Illinois, licensed in Illinois (085-006740) and active in the NPI registry since September 2018. She is enrolled in Medicare PECOS, is affiliated with Northshore University Healthsystem - Evanston Hospital, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1801379383

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameSOPHIA HOPE KANNENBERG O' BRYANCredential: PA-C

Location Address720 FLORSHEIM DRLibertyville, IL 60048-3757

Mailing Address1000 E Rollins RdRound Lake Beach, IL 60073-2228 · (847) 324-3976 · Fax (847) 929-1154

Phone(847) 247-4000

Fax(847) 234-2090

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateSeptember 11, 2018

Last NPPES UpdateAugust 2, 2023

NPPES CertifiedAugust 2, 2023

✔ NPI 1801379383 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in IL · 085-006740

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

720 FLORSHEIM DR, Libertyville, IL 60048

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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

Sophia Hope Kannenberg O' Bryan Pa-c 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 ID8325390537

PECOS Enrollment IDI20181016001093

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.

Areas of Expertise CMS Part B claims 4

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.

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.

71 services55 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

50 services39 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

25 services25 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

20 services18 patients

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

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

$74.38 typical visit price

range $19.15 – $147.12

Typical copayment $18.59 (range $4.78 – $36.78)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

93.08/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

80.79

Promoting Interoperability

100

Improvement Activities

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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