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JAKE ALAN KIMLICKA
NPI 1508529942
Nurse Anesthetist, Certified Registered in Maywood, IL

Active since October 21, 2021PECOS EnrolledAccepts Medicare Assignment
2160 S 1ST AVE, MAYWOOD, IL 60153(888) 584-7888 Get Directions Write a Review

NPPES record last updated: May 21, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 21, 2022, Oct 22, 2021 (2 updates tracked since 2021).

About Jake Alan Kimlicka NPPES

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

JAKE ALAN KIMLICKA (NPI 1508529942) is an individual nurse anesthetist, certified registered in Maywood, Illinois, licensed in Illinois (209.024183) and active in the NPI registry since October 2021. He is enrolled in Medicare PECOS, is affiliated with Adventist La Grange Memorial Hospital, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1508529942
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameJAKE ALAN KIMLICKA
Location Address2160 S 1ST AVEMaywood, IL 60153-3328
Mailing Address2160 S 1st AveMaywood, IL 60153-3328 · (708) 216-9000
Phone(888) 584-7888
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateOctober 21, 2021
Last NPPES UpdateMay 21, 20222 updates tracked since enumeration
NPPES CertifiedMay 21, 2022
✔ NPI 1508529942 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in IL · 209.024183
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
2160 S 1ST AVE, Maywood, IL 60153
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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

Jake Alan Kimlicka 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 ID4385032101
PECOS Enrollment IDI20211028000780
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

2

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

Loyola University Medical Center
0.1 mi
General Practice
2160 S 1ST AVE
Maywood, IL 60153
  • Reassigned Medicare billing, Illinois enrollment
  • 1,138 clinicians in this Medicare group
NPI 1336159961 (708) 216-3215
Gottlieb Midwest Anesthesiologists, LLC
3.4 mi
Anesthesiology
701 WEST NORTH AVENUE
Melrose Park, IL 60160
  • Reassigned Medicare billing, Illinois enrollment
  • 78 clinicians in this Medicare group
NPI 1003832767 (708) 681-3202

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

Areas of Expertise CMS Part B claims

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.

Anesthesia for other procedure on large bowel using an endoscope 00811
Anesthesia for an endoscopic procedure on the large bowel ensures comfort and relaxation during the procedure. You'll be given medication to make you drowsy or asleep, eliminating any discomfort. The medication can be administered through a vein or inhaled.
13 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Adventist La Grange Memorial Hospital

Acute Care Hospitals · La Grange, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140065
Location5101 S Willow Springs RdLa Grange, IL 60525 · Cook County
Emergency services

Loyola University Medical Center

Acute Care Hospitals · Maywood, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140276
Location2160 S 1st AvenueMaywood, IL 60153 · Cook County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60153 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
$138.86 typical visit price
range $60.08 – $183.39
Typical copayment $34.71 (range $15.02 – $45.84)
Most-billed visit code 99204
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
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.

ANITA OZA NAGAMINE M.D.
Radiology (Diagnostic Radiology)
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (708) 216-9000
DR. BRYCE ANDREW PASCHOLD D.P.M.
Podiatrist (Foot & Ankle Surgery)
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (708) 216-4254
DR. ANTONIO HERNANDO IGLESIAS M.D.
Psychiatry & Neurology (Neurology)
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (708) 216-9000
IAN CHARLES MCCOMB
Oral & Maxillofacial Surgery
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (708) 216-9000
JAMES WU D.O.
Psychiatry & Neurology (Psychiatry)
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (708) 216-9000
PAIGE T SONG MD
Student in an Organized Health Care Education/Training Program
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (888) 584-7888
ELIZABETH CHO
Orthopaedic Surgery
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (708) 216-1274
DR. CATHRYN T SAWALSKI DO, MBA
Internal Medicine
2160 S 1ST AVE
MAYWOOD, IL 60153
Cook County (888) 584-7888

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 Jake Kimlicka's NPI number?

The NPI number for Jake Kimlicka is 1508529942. It was assigned to this individual provider in the NPPES registry on October 21, 2021.

Where is Jake Kimlicka located?

Jake Kimlicka practices at 2160 S 1st Ave, Maywood, IL 60153. The listed phone number is (888) 584-7888.

What is Jake Kimlicka's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Jake Kimlicka enrolled in Medicare?

Yes. Jake Kimlicka is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Jake Kimlicka's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jake Kimlicka reassigns Medicare benefits to 2 organizations: Loyola University Medical Center (Maywood, IL) and Gottlieb Midwest Anesthesiologists, LLC (Melrose Park, IL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jake Kimlicka's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Jake Kimlicka affiliated with any hospitals?

According to CMS data, Jake Kimlicka is affiliated with Adventist La Grange Memorial Hospital and Loyola University Medical Center.

When was this NPI record last updated?

The NPPES record for Jake Kimlicka was last updated on May 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.