JESSICA NUSSBAUM PA-C
NPI 1184306524
Physician Assistant - Medical in Maryville, IL

Active since August 04, 2023PECOS EnrolledAccepts Medicare Assignment
6812 STATE ROUTE 162 STE 120, MARYVILLE, IL 62062(618) 288-0044 Get Directions Write a Review

NPPES record last updated: August 4, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Jessica Nussbaum Pa-c NPPES

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

JESSICA NUSSBAUM PA-C (NPI 1184306524) is an individual medical provider in Maryville, Illinois, licensed in Illinois (085.009880) and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS, is affiliated with Anderson Hospital, and is a graduate of Pennsylvania State University College Of Medicine (2023).

NPPES Registry Identity

NPI1184306524
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameJESSICA NUSSBAUMCredential: PA-C
Location Address6812 STATE ROUTE 162 STE 120Maryville, IL 62062-8586
Mailing Address8333 Goshen RdEdwardsville, IL 62025-6908 · (309) 310-7824
Sole ProprietorNo
Medical School CMSPennsylvania State University College Of MedicineGraduated 2023
Enumeration DateAugust 4, 2023
NPPES CertifiedAugust 4, 2023
NPI 1184306524 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License Licensed in IL · 085.009880
6812 STATE ROUTE 162 STE 120, Maryville, IL 62062

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

Jessica Nussbaum 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 ID8820451933
PECOS Enrollment IDI20230822003452
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

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

Anderson Hospital

Acute Care Hospitals · Maryville, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140289
Location6800 State Route 162Maryville, IL 62062 · Madison County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 4

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

Physician Assistant
6812 STATE ROUTE 162 STE 120
MARYVILLE, IL 62062
Physician Assistant
6812 STATE ROUTE 162 STE 120
MARYVILLE, IL 62062
Physician Assistant (Medical)
6812 STATE ROUTE 162 STE 120
MARYVILLE, IL 62062
Physician Assistant (Medical)
6812 STATE ROUTE 162 STE 120
MARYVILLE, IL 62062

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1184306524, enumerated as an "individual" on August 04, 2023.

The provider is located at 6812 STATE ROUTE 162 STE 120 MARYVILLE, IL 62062 and the phone number is (618) 288-0044.

Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.

The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter Health. Please consult your insurance carrier or call the provider to verify.

Jessica Nussbaum is affiliated with: ANDERSON HOSPITAL.