NPIMap

Individual provider Active NPI

Brian Patrick Jacquot, PA-C

  • Surgical Physician Assistant
  • Glenview, IL
National Provider Identifier
1053369546
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085001321 Issued in IL
Practice address
2100 Pfingsten Rd
Glenview, IL 60026-1301
Phone
(847) 657-5800
NPI assigned
May 5, 2006
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085001321 IL
Surgical Physician Assistant 363AS0400X 085001321 IL Primary
Surgical Physician Assistant 363AS0400X 10004104A IN

Addresses

Primary practice location

2100 Pfingsten Rd
Glenview, IL 60026-1301

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700
Phone (217) 876-2857

Other practice location 1

2300 N Edward St
Suite 2350
Decatur, IL 62526-4163
Phone (217) 876-2880

Other practice location 2

10590 N Meridian St Ste 105
Carmel, IN 46290-1028
Phone (317) 583-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA, IN, WI4 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20040817000633 IL Practitioner - Physician Assistant 7214900398 Reassigns benefits to 1 organization
I20230831000322 IA Practitioner - Physician Assistant 7214900398 Reassigns benefits to 1 organization
I20250121001116 IN Practitioner - Physician Assistant 7214900398 Reassigns benefits to 1 organization
I20251024003086 WI Practitioner - Physician Assistant 7214900398 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Medical Group, Inc.Group PAC ID 1052223625, 272 clinicians
Mercy Medical CenterGroup PAC ID 4183535271, 295 clinicians

Practice addresses (Care Compare)

425 Pine Ridge Blvd
Suite 209
Wausau, WI 54401-4123
Phone (715) 847-0400

701 10TH St SE
Cedar Rapids, IA 52403-1251

701 10TH St SE
Cedar Rapids, IA 52403-1292

701 10TH St SE J Edward Lundy
Mercy Pediatric Clinic
Cedar Rapids, IA 52403-1251
Phone (319) 832-2328

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085001321ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center CurrentSince Aug 1, 2023 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Oct 14, 2025 Accepting new patients
St. Vincent Medical Group, Inc. CurrentSince Jan 19, 2025 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Oct 14, 2025 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Oct 14, 2025 Accepting new patients
Aspirus Medical Group, Inc. Current Accepting new patients
Mercy Medical Center CurrentSince Aug 1, 2023 Accepting new patients
St. Vincent Medical Group, Inc. CurrentSince Jan 19, 2025 Accepting new patients
Aspirus Wausau Hospital, Inc. Current Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Oct 14, 2025 Accepting new patients
Carle Health Medical Group Past Accepting new patients
Mercy Physician Associates, Inc Past Accepting new patients
Decatur Emergency Medical Services II S C Past Accepting new patients
Illinois Cardiovascular & Thoracic Surgery, LTD Physician Assistant Past Accepting new patients

Locations

701 10th St SE
Cedar Rapids, IA 52403
Phone (319) 398-6011

788 8th Ave SE
Ste 300
Cedar Rapids, IA 52401
Phone (319) 369-4542

29980 Network Pl
Chicago, IL 60673

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

10590 N Meridian St
Ste 105
Carmel, IN 46290
Phone (317) 583-7800

250 W 96th St
Ste 520
Indianapolis, IN 46260
Phone (317) 583-3211

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

135 S Gibson St
Medford, WI 54451
Phone (715) 748-8100

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

425 Pine Ridge Blvd
Ste 209
Wausau, WI 54401
Phone (715) 845-4606

4005 Community Center Dr
Weston, WI 54476
Phone (715) 241-5400

Interoperability endpoints

  • Direct secure messaging: bjacquot439698@direct.aspirus.org

Organizations & group practices 19

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 19

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1053369546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "217-876-2857",
            "fax_number": "217-876-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 PFINGSTEN RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261301",
            "telephone_number": "847-657-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 N Edward St",
            "address_2": "Suite 2350",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625264163",
            "country_code": "US",
            "telephone_number": "217-876-2880",
            "fax_number": "217-876-2885",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10590 N Meridian St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "462901028",
            "country_code": "US",
            "telephone_number": "317-583-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACQUOT",
        "first_name": "BRIAN",
        "middle_name": "PATRICK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001321",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085001321",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IN",
            "license": "10004104A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

Verify at the official NPI Registry.