Justin L Northcutt, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085007547 Issued in IL

Practice address

8 Doctors Park Rd
Mount Vernon, IL 62864-6224

Phone

(618) 244-5500

NPI assigned

Mar 17, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, MO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Saint Louis University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Signature Medical Group Inc 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Jefferson Hospital, Crystal City, MO, CCN 260023
• SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: justin.northcutt@direct.signature.nextgenshare.com

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.

• Signature Medical Group, Inc

  • Orthopaedic Surgery Physician
  • Saint Louis, MO
  • NPI 1871542761

  MO

  Medicare reassignment Care Compare group NPD
• Signature Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Chesterfield, MO
  • NPI 1982473153
  Care Compare group NPD
• Deaconess Illinois Specialty Clinic, Inc.

  • Surgery Physician
  • Marion, IL
  • NPI 1972210235

  IL

  Medicare reassignment
• Signature Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Saint Louis, MO
  • NPI 1649201864
  Care Compare group
• Signature Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Fenton, MO
  • NPI 1942431606
  Care Compare group
• Deaconess Illinois Specialty Clinic, Inc.

  • Orthopaedic Surgery Physician
  • Anna, IL
  • NPI 1134836612
  NPD
• Deaconess Illinois Specialty Clinic, Inc.

  • Hospitalist Physician
  • Anna, IL
  • NPI 1225858251

  Physician Assistant

  NPD
• Heartland Rural Healthcare, LLC

  • Family Medicine Physician
  • Marion, IL
  • NPI 1316009582
  NPD (past)
• Specialists in Medical Imaging, SC

  • Diagnostic Radiology Physician
  • Olympia Fields, IL
  • NPI 1841687951

  Physician Assistant

  NPD (past)

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

• Mercy Hospital Jefferson

  • General Acute Care Hospital
  • Festus, MO
  • NPI 1508859661

  Hospital

  Care Compare affiliation
• SSM Select Rehab St Louis LLC

  • Rehabilitation Hospital
  • Richmond Heights, MO
  • NPI 1659511988

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1194351668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12415 SOMERSET PLACE DR APT J",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 DOCTORS PARK RD",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646224",
            "telephone_number": "618-244-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTHCUTT",
        "first_name": "JUSTIN",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-17",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neuromuscular Orthopaedic Institute LTD
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• Azure Newman, MHP
• Paige Niepoetter, FNP
• Daniel Northcutt, OTR/L
• Northland Hearing Centers, Inc.
• Charlet R Nowland, R.N.
• Marjorie Mabong Nwosu, M.D.
• Kathy O'Brien
• Angela K Oglesby, OTR/L

• All providers in Mount Vernon, IL
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.