MRS. MICHELLE VERONICA JACOB AGNP
NPI 1033548045
Nurse Practitioner - Adult Health in Belleville, IL

Active since November 11, 2013PECOS EnrolledAccepts Medicare Assignment
92.39/100
CMS Quality Rating
4500 MEMORIAL DR, DEPT ANESTHESIOLOGY, BELLEVILLE, IL 62226(800) 862-9980(314) 362-7785 Get Directions Write a Review

NPPES record last updated: April 21, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 15, 2021, Nov 12, 2021, Jul 26, 2018 (3 updates tracked since 2018).

About Mrs. Michelle Veronica Jacob Agnp NPPES

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

MRS. MICHELLE VERONICA JACOB AGNP (NPI 1033548045) is an individual adult health provider in Belleville, Illinois, licensed in Illinois (209011680) and active in the NPI registry since November 2013. She is enrolled in Medicare PECOS, is affiliated with Memorial Hospital, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1033548045
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameMRS. MICHELLE VERONICA JACOBCredential: AGNP
Location Address4500 MEMORIAL DR, DEPT ANESTHESIOLOGYBelleville, IL 62226-5360
Mailing AddressPo Box 7412011Chicago, IL 60674-2011 · (800) 862-9980 · Fax (314) 362-7785
Fax(314) 362-7785
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateNovember 11, 2013
Last NPPES UpdateApril 21, 20253 updates tracked since enumeration
NPI 1033548045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License Licensed in IL · 209011680
4500 MEMORIAL DR, Belleville, IL 62226

Other Identifiers 1

Medicaid420022730MO

Accepted Insurance

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

Mrs. Michelle Veronica Jacob Agnp 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 ID9436462066
PECOS Enrollment IDI20160330001486
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 2

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
79 services44 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
67 services34 patients

Hospital Affiliations CMS Care Compare

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

Memorial Hospital

Acute Care Hospitals · Belleville, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140185
Location4500 Memorial DriveBelleville, IL 62226 · St. Clair County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62226 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
$88.44 typical visit price
range $56.28 – $173.35
Typical copayment $22.11 (range $14.07 – $43.33)
Most-billed visit code 99203
Established Patient
$99.71 typical visit price
range $17.51 – $139.99
Typical copayment $24.92 (range $4.37 – $34.99)
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.

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.

92.39/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality97.81
Promoting Interoperability100
Improvement Activities40
Cost70.26

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.

Internal Medicine
4500 MEMORIAL DR
BELLEVILLE, IL 62226
Radiology (Diagnostic Radiology)
4500 MEMORIAL DR, DEPT RADIOLOGY
BELLEVILLE, IL 62226
Nurse Anesthetist, Certified Registered
4500 MEMORIAL DR
BELLEVILLE, IL 62226
Radiology (Diagnostic Radiology)
4500 MEMORIAL DR, DEPT OF RADIOLOGY
BELLEVILLE, IL 62226
Nurse Anesthetist, Certified Registered
4500 MEMORIAL DR
BELLEVILLE, IL 62226
Physical Therapist
4500 MEMORIAL DR
BELLEVILLE, IL 62226
Physical Therapist
4500 MEMORIAL DR
BELLEVILLE, IL 62226
Physical Therapist
4500 MEMORIAL DR
BELLEVILLE, IL 62226

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1033548045, enumerated as an "individual" on November 11, 2013.

The provider is located at 4500 MEMORIAL DR DEPT ANESTHESIOLOGY BELLEVILLE, IL 62226 and the phone number is (800) 862-9980.

Nurse Practitioner with taxonomy code 363LA2200X and a focus in Adult Health.

The provider might be accepting Accepts: Cox HealthPlans, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.

Michelle Jacob is affiliated with: MEMORIAL HOSPITAL.