Jennifer M Illig, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA052572 Issued in PA

Practice address

1850 E Park Ave Ste 201
State College, PA 16803-6706

Phone

(844) 278-4600

Fax

(814) 235-1133

NPI assigned

Sep 13, 2006

Last updated

Dec 19, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Marie Long Former name

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mount Nittany Medical Center Health Services IncGroup PAC ID 8426136797, 366 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Nittany Medical Center Hospital, State College, PA, CCN 390268

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Mount Nittany Medical Center Health Services Inc

  dba Mount Nittany Physician Group

  • Internal Medicine Physician
  • State College, PA
  • NPI 1598992554
  Medicare reassignment Care Compare group
• Windber Hospital, Inc.

  dba Windber Medical Center

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

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

• Mount Nittany Medical Center

  dba Mount Nittany Pain Center

  • Pain Clinic/Center
  • State College, PA
  • NPI 1104991801

  Hospital

  Care Compare affiliation
• Mount Nittany Medical Center

  • Clinic/Center
  • State College, PA
  • NPI 1194521302

  Hospital

  Care Compare affiliation
• Mount Nittany Medical Center

  • General Acute Care Hospital
  • State College, PA
  • NPI 1730173154
  Care Compare affiliation
• Mount Nittany Medical Center

  dba Mount Nittany Surgical Center

  • Ambulatory Surgical Clinic/Center
  • State College, PA
  • NPI 1780750620

  Hospital

  Care Compare affiliation
• Mount Nittany Medical Center

  • Ambulatory Surgical Clinic/Center
  • State College, PA
  • NPI 1780752378

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1245335660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE STE 201",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "844-278-4600",
            "fax_number": "814-235-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE STE 201",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "844-278-4600",
            "fax_number": "814-235-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILLIG",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA052572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "LONG",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christine Ellen Hurd, PT
• Matthew Hutchinson, PHARM D.
• Kenneth William Hylbert, M.D.
• Brian A. Hyman, M.D.
• Joyce Illfelder-Kaye, PH.D.
• Sylvia M Immel, PA-C, MMSC.
• In-Home Care Services LLC
• Individual and Family Choices Program
• Insights Therapy, LLC
• Integrative Health Care Associates

• Medical Physician Assistant in State College, PA
• Providers in State College, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; 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.