Individual provider Active NPI

Jacob Robert Fenster

  • Emergency Medicine Physician
  • Quincy, IL
National Provider Identifier
1134668189
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036156624 Issued in IL
Practice address
1005 Broadway St
Quincy, IL 62301-2834
Phone
(217) 223-8400
Fax
(217) 223-6894
NPI assigned
Feb 22, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036156624 IL Primary

Addresses

Primary practice location

1005 Broadway St
Quincy, IL 62301-2834

Mailing address

1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210622000306 IL Practitioner - Emergency Medicine 3173872033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Alabama College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blessing HospitalGroup PAC ID 3072422534, 414 clinicians

Practice addresses (Care Compare)

1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Blessing Hospital Current Accepting new patients
Blessing Hospital CurrentSince Jul 1, 2021 Accepting new patients
George County Hospital Current Accepting new patients
Blessing Hospital CurrentSince Jul 1, 2021 Accepting new patients

Locations

640 W Washington St
Pittsfield, IL 62363
Phone (217) 285-2113

1005 Broadway St
Quincy, IL 62301

3200 Broadway St
Quincy, IL 62301
Phone (217) 224-0776

859 Winter St
Lucedale, MS 39452
Phone (601) 766-4286

Interoperability endpoints

  • FHIR API: https://fhir.blessinghospital.com/R4/open-Prod
  • Direct secure messaging: jacobfenster@grh.medalliesdirect.net

Organizations & group practices 4

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

Hospital & facility affiliations 2

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": "1487721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1134668189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-8400",
            "fax_number": "217-277-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-8400",
            "fax_number": "217-223-6894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENSTER",
        "first_name": "JACOB",
        "middle_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-22",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036156624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.