Individual provider Active NPI

Jill Elizabeth Coster, DO

  • Family Medicine Physician
  • O'Fallon, IL
National Provider Identifier
1205462942
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.164563 Issued in IL
Practice address
3 Saint Elizabeth Blvd Ste 4000
O Fallon, IL 62269-1284
Phone
(618) 256-9355
NPI assigned
Mar 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036.164563 IL Primary

Addresses

Primary practice location

3 Saint Elizabeth Blvd Ste 4000
O Fallon, IL 62269-1284

Mailing address

3 Saint Elizabeth Blvd Ste 4000
O Fallon, IL 62269-1284
Phone (618) 256-9355

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jill.coster.1@9559.direct.athenahealth.com Direct

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
I20231013002224 IL Practitioner - Family Practice 7810382413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3 Saint Elizabeth Blvd
Suite 4000
O Fallon, IL 62269-1284
Phone (618) 233-5480

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.164563ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Healthcare Foundation Inc Family Medicine Current Accepting new patients
Southern Illinois Healthcare Foundation Inc CurrentSince Aug 24, 2023 Accepting new patients
Southern Illinois Health Care Foundation, Inc. Family Medicine CurrentSince Aug 24, 2023 Accepting new patients

Locations

6000 Bond Ave
East Saint Louis, IL 62207
Phone (618) 332-2740

2001 State St
East St Louis, IL 62205
Phone (618) 271-0204

3 Saint Elizabeth Blvd
Ste 4000
O Fallon, IL 62269
Phone (618) 233-5480

2041 Goose Lake Rd
Sauget, IL 62206

Interoperability endpoints

  • Direct secure messaging: jill.coster.1@9559.direct.athenahealth.com

Organizations & group practices 3

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 1

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": "1584057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1205462942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SAINT ELIZABETH BLVD STE 4000",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691284",
            "telephone_number": "618-256-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SAINT ELIZABETH BLVD STE 4000",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691284",
            "telephone_number": "618-256-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTER",
        "first_name": "JILL",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-13",
        "last_updated": "2023-10-12",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.164563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jill.coster.1@9559.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "3 Saint Elizabeth Blvd Ste 4000",
            "city": "O Fallon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622691284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in O'Fallon, IL

Sources for this page

Verify at the official NPI Registry.