MR. JACOB SMITH PA-C, ATC
NPI 1548675945
Physician Assistant in Bloomington, IL

Q: What is Jacob Smith's NPI number?

The NPI number for Jacob Smith is 1548675945. It was assigned to this individual provider in the NPPES registry on June 24, 2014.

Q: What is Jacob Smith's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jacob Smith was last updated on March 30, 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.

Active since June 24, 2014PECOS EnrolledAccepts Medicare Assignment

1111 TRINITY LN STE 111, BLOOMINGTON, IL 61704(309) 663-6461 Get Directions Write a Review

NPPES record last updated: March 30, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 10, 2021, Aug 23, 2021, Aug 16, 2021 and 2 more (5 updates tracked since 2020).

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About Mr. Jacob Smith Pa-c, Atc NPPES

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

MR. JACOB SMITH PA-C, ATC (NPI 1548675945) is an individual physician assistant in Bloomington, Illinois, licensed in Illinois (085008559) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS, is affiliated with Carle Bromenn Medical Center, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1548675945

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. JACOB SMITHCredential: PA-C, ATC

Location Address1111 TRINITY LN STE 111Bloomington, IL 61704-8112

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

Phone(309) 663-6461

Sole ProprietorYes

Medical School CMSOtherGraduated 2021

Enumeration DateJune 24, 2014

Last NPPES UpdateMarch 30, 20225 updates tracked since enumeration

NPPES CertifiedMarch 22, 2022

✔ NPI 1548675945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in IL · 085008559

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.

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 085008559 (IL)

1111 TRINITY LN STE 111, Bloomington, IL 61704

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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. Jacob Smith Pa-c, Atc 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 ID4789081944

PECOS Enrollment IDI20210930002333

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 11

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.

Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg J7328

Gelsyn-3 is a treatment involving injections of a substance called hyaluronan into the joint space. Hyaluronan is naturally present in healthy joint fluid, aiding in lubrication and shock absorption. This treatment helps relieve joint pain, often in conditions like osteoarthritis.

8,736 services20 patients

Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg J7318

Hyaluronan or derivative, Durolane, is a treatment injected directly into the joint to relieve pain and improve mobility. It's often used for arthritis in the knee. The substance works by supplementing your body's natural joint fluid to help lubricate and cushion the joint.

1,140 services12 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

220 services27 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.

136 services104 patients

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.

82 services65 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

81 services54 patients

Hospital Affiliations CMS Care Compare 2

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

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

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 61704 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. JOHN JUNIL KIM DPM

Podiatrist (Foot & Ankle Surgery)