Mr Jacob Smith, PA-C, ATC - Medicare Physician Assistant in Bloomington, IL

Mr Jacob Smith, PA-C, ATC is a medicare enrolled "Physician Assistant" in Bloomington, Illinois. He graduated from nursing school in 2021 and has 3 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Carle West Physician Group Inc and his current practice location is 1111 Trinity Ln Ste 111, Bloomington, Illinois. You can reach out to his office (for appointments etc.) via phone at (309) 663-6461.

Mr Jacob Smith is licensed to practice in Illinois (license number 085008559) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1548675945.

Contact Information

Mr Jacob Smith, PA-C, ATC
1111 Trinity Ln Ste 111,
Bloomington, IL 61704-8112
(309) 663-6461
Not Available

Map and Direction




Provider's Profile

Full NameMr Jacob Smith
GenderMale
SpecialityPhysician Assistant
Experience3 Years
Location1111 Trinity Ln Ste 111, Bloomington, Illinois
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mr Jacob Smith graduated from nursing school in 2021
  NPI Data:
  • NPI Number: 1548675945
  • Provider Enumeration Date: 06/24/2014
  • Last Update Date: 03/30/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 4789081944
  • Enrollment ID: I20210930002333

Medical Identifiers

Medical identifiers for Mr Jacob Smith such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1548675945NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AM0700XPhysician Assistant - Medical 085008559 (Illinois)Secondary
363A00000XPhysician Assistant 085008559 (Illinois)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Advocate Bromenn Medical CenterNormal, ILHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Carle West Physician Group Inc8921420308283

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jacob Smith is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Jacob Smith, PA-C, ATC
611 W. Park St., Fapc,
Urbana, IL 61801

Ph: () -
Mr Jacob Smith, PA-C, ATC
1111 Trinity Ln Ste 111,
Bloomington, IL 61704-8112

Ph: (309) 663-6461

Reviews and Comments


Physician Assistant Nurses in Bloomington, IL

Amy J Stites, PA-C
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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

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