1. Home
  2. Directory
  3. Illinois
  4. Peoria
  5. Physician Assistant
  6. NPI Profile

JASON ROACH PA-C
NPI 1104179795
Physician Assistant in Peoria, IL

Active since October 19, 2012PECOS Enrolled
530 NE GLEN OAK AVE, PEORIA, IL 61637(309) 655-2036 Get Directions Write a Review

NPPES record last updated: October 19, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jason Roach Pa-c NPPES

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

JASON ROACH PA-C (NPI 1104179795) is an individual physician assistant in Peoria, Illinois, licensed in Illinois (085.004474) and active in the NPI registry since October 2012. He is enrolled in Medicare PECOS, is affiliated with Saint Francis Medical Center, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1104179795
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJASON ROACHCredential: PA-C
Location Address530 NE GLEN OAK AVEPeoria, IL 61637-0001
Mailing Address280 E Greenwood StMorton, IL 61550-2572 · (815) 674-0887
Phone(309) 655-2036
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateOctober 19, 2012
✔ NPI 1104179795 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in IL · 085.004474
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.
530 NE GLEN OAK AVE, Peoria, IL 61637
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 (PECOS)

Jason Roach Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1850520008
PECOS Enrollment IDI20140210001245
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.

Hospital Affiliations CMS Care Compare 4

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

Saint Francis Medical Center

Acute Care Hospitals · Peoria, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140067
Location530 NE Glen Oak AvePeoria, IL 61637 · Peoria County
Emergency services Birthing friendly

Carle Bromenn Medical Center

Acute Care Hospitals · Normal, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140127
Location1304 Franklin AvenueNormal, IL 61761 · Mc Lean County
Emergency services Birthing friendly

Methodist Medical Center Of Illinois

Acute Care Hospitals · Peoria, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140209
Location221 N E Glen Oak AvePeoria, IL 61636 · Peoria County
Emergency services Birthing friendly

Carle Eureka Hospital

Critical Access Hospitals · Eureka, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141309
Location101 S Major StEureka, IL 61530 · Woodford County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61637 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.

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. DEEPAK S NAIR M.D.
Psychiatry & Neurology (Neurology)
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
DR. HAMID MAHMOOD ZIA M.D
Pathology (Anatomic Pathology & Clinical Pathology)
530 NE GLEN OAK AVE, CENTRAL ILLINOIS PATHOLOGY SC
PEORIA, IL 61637
Peoria County (309) 624-9011
THOMAS JAMES MCMORROW MD
Pediatrics
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2553
ERIC TYLER AMPARAN MD
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2274
ALEXANDRA ROPER MD
Surgery
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
JAPMEHR KAUR SANDHU M.B.B.S.
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 624-9351
THOMAS BLACKWELL JR. MD
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2000
LUKE KLOFT
Student in an Organized Health Care Education/Training Program
530 NE GLEN OAK AVE
PEORIA, IL 61637
Peoria County (309) 655-2109

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 Jason Roach's NPI number?

The NPI number for Jason Roach is 1104179795. It was assigned to this individual provider in the NPPES registry on October 19, 2012.

Where is Jason Roach located?

Jason Roach practices at 530 NE Glen Oak Ave, Peoria, IL 61637. The listed phone number is (309) 655-2036.

What is Jason Roach's specialty?

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

Is Jason Roach enrolled in Medicare?

Yes. Jason Roach is registered in the Medicare PECOS enrollment system.

Is Jason Roach affiliated with any hospitals?

According to CMS data, Jason Roach is affiliated with Saint Francis Medical Center, Carle Bromenn Medical Center, Methodist Medical Center Of Illinois and Carle Eureka Hospital.

When was this NPI record last updated?

The NPPES record for Jason Roach was last updated on October 19, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.