NPIMap

Individual provider Active NPI

Jason E Barnett, MD

  • Family Medicine Physician
  • Maryville, IL
National Provider Identifier
1295728988
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036104914 Issued in IL
Practice address
6812 State Route 162
Suite 120
Maryville, IL 62062-8553
Phone
(618) 288-0044
Fax
(618) 288-0066
NPI assigned
Aug 26, 2005
Last updated
Jan 14, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

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 036104914 IL Primary

Addresses

Primary practice location

6812 State Route 162
Suite 120
Maryville, IL 62062-8553

Mailing address

6812 State Route 162
Suite 120
Maryville, IL 62062-8553
Phone (618) 288-0044

Other identifiers 3

IdentifierTypeStateIssuer
036104914004MedicaidIL
036104914MedicaidIL
P00437778OtherILRR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040610000387 IL Practitioner - Family PracticePractitioner - Emergency Medicine 7911980032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anderson Medical Group LLCGroup PAC ID 5193792018, 136 clinicians

Practice addresses (Care Compare)

6812 State Route 162
Suite 120
Maryville, IL 62062-8586
Phone (618) 288-0044

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.76 of 100Reported as group
Quality
54.98
Promoting interoperability
85
Improvement activities
40
Cost
73.39

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Medical Group, LLC Family Medicine CurrentSince Apr 13, 2007 Accepting new patients
Granite City Clinic Corp Past Accepting new patients
Midwest Emergency Management, Inc. Past Accepting new patients
Granite City Physicians Corp Past Accepting new patients

Locations

17 Ginger Creek Mdws
Glen Carbon, IL 62034
Phone (618) 656-9777

6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095

6810 State Route 162
Ste 215
Maryville, IL 62062
Phone (618) 391-6405

6812 State Route 162
Ste 120
Maryville, IL 62062
Phone (618) 288-0044

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358121600000",
    "number": "1295728988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6812 STATE ROUTE 162",
            "address_2": "SUITE 120",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628553",
            "telephone_number": "618-288-0044",
            "fax_number": "618-288-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6812 STATE ROUTE 162",
            "address_2": "SUITE 120",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628553",
            "telephone_number": "618-288-0044",
            "fax_number": "618-288-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNETT",
        "first_name": "JASON",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2013-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036104914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036104914004",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036104914",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00437778",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

Verify at the official NPI Registry.