JEREMY ELLIOTT
NPI 1003416546
Nurse Practitioner - Family in Springfield, IL

Q: What is Jeremy Elliott's NPI number?

The NPI number for Jeremy Elliott is 1003416546. It was assigned to this individual provider in the NPPES registry on October 26, 2020.

Q: What is Jeremy Elliott's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jeremy Elliott was last updated on November 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 October 26, 2020PECOS EnrolledAccepts Medicare Assignment

1025 S 6TH ST, SPRINGFIELD, IL 62703(217) 528-7541 Get Directions Write a Review

NPPES record last updated: November 1, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 10, 2022, Oct 26, 2020 (2 updates tracked since 2020).

On this page

About Jeremy Elliott NPPES

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

JEREMY ELLIOTT (NPI 1003416546) is an individual family provider in Springfield, Illinois, licensed in Illinois (209022227) and active in the NPI registry since October 2020. He is enrolled in Medicare PECOS, is affiliated with Thomas H Boyd Memorial Hospital, and maintains a secondary practice location in White Hall.

NPPES Registry Identity

NPI1003416546

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameJEREMY ELLIOTT

Location Address1025 S 6TH STSpringfield, IL 62703-2499

Mailing AddressPo Box 19248Springfield, IL 62794-9248

Phone(217) 528-7541

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateOctober 26, 2020

Last NPPES UpdateNovember 1, 20242 updates tracked since enumeration

NPPES CertifiedNovember 1, 2024

✔ NPI 1003416546 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 · 209022227

1025 S 6TH ST, Springfield, IL 62703

Open in Google Maps ↗

Secondary Practice Location 1

Location 1116A N Main StWhite Hall, IL 62092-1054 · Phone (217) 374-2188

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.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

Jeremy Elliott 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 ID3678984556

PECOS Enrollment IDI20201125000758

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

Medicare enrollment records show Jeremy Elliott reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Springfield Clinic, LLP

Same address

Multi-Specialty

1025 S 6TH ST
Springfield, IL 62703

Reassigned Medicare billing, Illinois enrollment
735 clinicians in this Medicare group

NPI 1780638478 (217) 528-7541

Thomas H. Boyd Memorial Hospital

53 mi

Critical Access

800 SCHOOL ST
Carrollton, IL 62016

Reassigned Medicare billing, Illinois enrollment
37 clinicians in this Medicare group

NPI 1811096811 (217) 942-6946

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

Hospital Affiliations CMS Care Compare

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

Thomas H Boyd Memorial Hospital

Critical Access Hospitals · Carrollton, IL

OwnershipGovernment - Local

CMS Certification Number141300

Location800 School StCarrollton, IL 62016 · Greene County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62703 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

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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 20

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

BARBARA J. WOLFSON L.C.P.C.

Counselor