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JERRY PRIDDY PA-C
NPI 1003351115
Physician Assistant in Springfield, IL

Active since December 28, 2016PECOS EnrolledAccepts Medicare Assignment
619 E MASON ST STE 5, SPRINGFIELD, IL 62701(217) 545-8000(217) 545-2552 Get Directions Write a Review

NPPES record last updated: December 18, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 18, 2024, Apr 13, 2020, Sep 25, 2018 and 2 more (5 updates tracked since 2016).

About Jerry Priddy Pa-c NPPES

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

JERRY PRIDDY PA-C (NPI 1003351115) is an individual physician assistant in Springfield, Illinois, licensed in Illinois (085006117) and active in the NPI registry since December 2016. He is enrolled in Medicare PECOS, is affiliated with St Johns Hospital, and maintains a secondary practice location in Springfield.

NPPES Registry Identity

NPI1003351115
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJERRY PRIDDYCredential: PA-C
Location Address619 E MASON ST STE 5Springfield, IL 62701-1080
Mailing AddressPo Box 19639Springfield, IL 62794-9639 · (217) 545-8000
Phone(217) 545-8000
Fax(217) 545-2552
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateDecember 28, 2016
Last NPPES UpdateDecember 18, 20245 updates tracked since enumeration
NPPES CertifiedDecember 18, 2024
✔ NPI 1003351115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in IL · 085006117
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.
Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License 085006117 (IL)
619 E MASON ST STE 5, Springfield, IL 62701
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Secondary Practice Location 1

Location 11301 S Koke Mill RdSpringfield, IL 62711 · Phone (217) 547-9100 · Fax (217) 547-9236

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

Jerry Priddy 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 ID3779869250
PECOS Enrollment IDI20170418001025
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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
34 services22 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
33 services26 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
15 services15 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

St Johns Hospital

Acute Care Hospitals · Springfield, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140053
Location800 E Carpenter StSpringfield, IL 62769 · Sangamon County
Emergency services Birthing friendly

Memorial Medical Center

Acute Care Hospitals · Springfield, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140148
Location701 N First StSpringfield, IL 62702 · Sangamon County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62701 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
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.

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 Jerry Priddy's NPI number?

The NPI number for Jerry Priddy is 1003351115. It was assigned to this individual provider in the NPPES registry on December 28, 2016.

Where is Jerry Priddy located?

Jerry Priddy practices at 619 E Mason St Ste 5, Springfield, IL 62701. The listed phone number is (217) 545-8000.

What is Jerry Priddy's specialty?

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

Is Jerry Priddy enrolled in Medicare?

Yes. Jerry Priddy 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.

Is Jerry Priddy affiliated with any hospitals?

According to CMS data, Jerry Priddy is affiliated with St Johns Hospital and Memorial Medical Center.

When was this NPI record last updated?

The NPPES record for Jerry Priddy was last updated on December 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.