JAN MIRIAM JACOB-WICKLAND PA-C
NPI 1508980541
Physician Assistant in Saint Louis, MO

Q: What is Jan Jacob-wickland's NPI number?

The NPI number for Jan Jacob-wickland is 1508980541. It was assigned to this individual provider in the NPPES registry on March 16, 2007.

Q: What is Jan Jacob-wickland's specialty?

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

Active since March 16, 2007PECOS EnrolledAccepts Medicare Assignment

615 S NEW BALLAS RD DEPT OF, SAINT LOUIS, MO 63141(314) 251-6000(636) 386-7679 Get Directions Write a Review

NPPES record last updated: February 20, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Jan Miriam Jacob-wickland Pa-c NPPES

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

JAN MIRIAM JACOB-WICKLAND PA-C (NPI 1508980541) is an individual physician assistant in Saint Louis, Missouri, licensed in Missouri (119559) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS, is affiliated with Mercy Hospital St Louis, and maintains a secondary practice location in Saint Louis.

NPPES Registry Identity

NPI1508980541

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameJAN MIRIAM JACOB-WICKLANDCredential: PA-C

Location Address615 S NEW BALLAS RD DEPT OFSaint Louis, MO 63141-8221

Mailing Address1054 Big Bend Station DrManchester, MO 63088-1429 · (636) 861-1102

Phone(314) 251-6000

Fax(636) 386-7679

Sole ProprietorNo

Medical School CMSOtherGraduated 1986

Enumeration DateMarch 16, 2007

Last NPPES UpdateFebruary 20, 2019

✔ NPI 1508980541 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 MO · 119559

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.

615 S NEW BALLAS RD DEPT OF, Saint Louis, MO 63141

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Secondary Practice Location 1

Location 11 Barnes Jewish Hospital PlzSaint Louis, MO 63110-1003 · Phone (314) 454-8134

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.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

Jan Miriam Jacob-wickland 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 ID6002155645

PECOS Enrollment IDI20190226003528

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 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

166 services165 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

136 services136 patients

Hospital Affiliations CMS Care Compare

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

Mercy Hospital St Louis

Acute Care Hospitals · Saint Louis, MO

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260020

Location615 New Ballas RoadSaint Louis, MO 63141 · St. Louis County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63141 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

$86.32 typical visit price

range $55.65 – $169.38

Typical copayment $21.58 (range $13.91 – $42.34)

Most-billed visit code 99203

Established Patient

$69.50 typical visit price

range $17.76 – $137.92

Typical copayment $17.37 (range $4.44 – $34.48)

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.

MRS. MARIA JONES C-AA

Anesthesiologist Assistant