MR. JUSTIN MATTHEW JEFFERSON
NPI 1073238440
Nurse Practitioner - Family in Urbana, IL

Q: What is Justin Jefferson's NPI number?

The NPI number for Justin Jefferson is 1073238440. It was assigned to this individual provider in the NPPES registry on October 7, 2022.

Q: What is Justin Jefferson'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 Justin Jefferson was last updated on May 5, 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 October 07, 2022PECOS EnrolledAccepts Medicare Assignment

611 W PARK ST, URBANA, IL 61801(217) 326-4325 Get Directions Write a Review

NPPES record last updated: May 5, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 5, 2023, Oct 7, 2022 (2 updates tracked since 2022).

On this page

About Mr. Justin Matthew Jefferson NPPES

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

MR. JUSTIN MATTHEW JEFFERSON (NPI 1073238440) is an individual family provider in Urbana, Illinois, licensed in Illinois (209025128) and active in the NPI registry since October 2022. He is enrolled in Medicare PECOS, is affiliated with Carle Foundation Hospital, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1073238440

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameMR. JUSTIN MATTHEW JEFFERSON

Location Address611 W PARK STUrbana, IL 61801-2529

Mailing Address611 W. Park St., FapcUrbana, IL 61801

Phone(217) 326-4325

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateOctober 7, 2022

Last NPPES UpdateMay 5, 20232 updates tracked since enumeration

NPPES CertifiedApril 26, 2023

✔ NPI 1073238440 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in IL · 209025128

Also ListedNurse PractitionerTaxonomy 363L00000X · License 209.025128 (IL)

611 W PARK ST, Urbana, IL 61801

Open in Google Maps ↗

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

Mr. Justin Matthew Jefferson 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 ID9830562438

PECOS Enrollment IDI20230301002543

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 7

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.

Removal of skin and tissue, 20.0 sq cm or less 11042

This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.

233 services82 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

199 services77 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.

61 services35 patients

Removal of tissue from wound, 20.0 sq cm or less 97597

This procedure involves the careful removal of damaged or infected tissue from a wound that's 20.0 square cm or less. It's done to promote healing and prevent further infection. The process is carried out under local anesthesia, ensuring minimal discomfort.

52 services28 patients

Removal of skin and tissue, each additional 20.0 sq cm or less 11045

This procedure involves the removal of skin and tissue, typically due to disease, injury, or abnormal growth. Each session removes an area of 20.0 square cm or less. It's performed by a trained professional and may require multiple sessions for larger areas.

23 services11 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

23 services23 patients

Hospital Affiliations CMS Care Compare

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

Carle Foundation Hospital

Acute Care Hospitals · Urbana, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140091

Location611 West Park StreetUrbana, IL 61801 · Champaign County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61801 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.

Leave this field empty

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.

DR. UDAY BHASKAR KANAKADANDI MD

Internal Medicine (Interventional Cardiology)

611 W PARK ST, HVI
URBANA, IL 61801

Champaign County (217) 383-3110

DR. VIKAS DESAI MD

Urology