Jay A Pickett, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036 081291 Issued in IL

Practice address

509 Hamacher St
Suite 102
Waterloo, IL 62298-1592

Phone

(618) 939-3939

Fax

(618) 939-3941

NPI assigned

Feb 10, 2006

Last updated

Feb 17, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

University of Chicago, Pritzker School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tauc Il PCGroup PAC ID 3173060282, 17 clinicians

Total Access Urgent Care PCGroup PAC ID 8820171929, 130 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

42.87 of 100Reported as group

Quality

31.86

Promoting interoperability

0

Improvement activities

40

Cost

61.04

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1588/brand/1/csg/121/fhir/r4

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.

• Tauc Il, PC

  dba Total Access Urgent Care

  • Urgent Care Clinic/Center
  • Collinsville, IL
  • NPI 1487401709
  Medicare reassignment Care Compare group NPD
• Total Access Urgent Care, PC

  dba Total Access Urgent Care

  • Urgent Care Clinic/Center
  • Saint Louis, MO
  • NPI 1962684886
  Medicare reassignment Care Compare group NPD
• Family Practice Associates, PC

  • Family Medicine Physician
  • Waterloo, IL
  • NPI 1861688541
  Authorized official Same address or phone
• Total Access Urgent Care, PC

  dba Total Access Urgent Care

  • Urgent Care Clinic/Center
  • Saint Louis, MO
  • NPI 1952729402

  Family Medicine

  NPD
• DRS Pichet & Meechai

  • Internal Medicine Physician
  • Red Bud, IL
  • NPI 1417058777
  NPD (past)
• Heartland Rural Healthcare, LLC

  • Family Medicine Physician
  • Marion, IL
  • NPI 1275166134
  NPD (past)
• Pamella S Gronemeyer

  dba SEMC Pathology

  • Clinical Medical Laboratory
  • Highland, IL
  • NPI 1194874966
  NPD (past)
• Tauc Il, PC

  dba Total Access Urgent Care

  • Urgent Care Clinic/Center
  • O'Fallon, IL
  • NPI 1407439524
  NPD (past)
• DRX - FC Management 002, LLC

  dba Doctors Express - Creve Coeur

  • Urgent Care Clinic/Center
  • Saint Louis, MO
  • NPI 1316245780
  NPD (past)
• Total Access Urgent Care P.C.

  dba Total Access Urgent Care

  • Urgent Care Clinic/Center
  • Saint Louis, MO
  • NPI 1356823397
  NPD (past)
• Total Access Urgent Care, PC

  dba Total Access Urgent Care

  • Urgent Care Clinic/Center
  • Saint Louis, MO
  • NPI 1013440593
  NPD (past)
• Total Access Urgent Care, PC

  dba Total Access Urgent Care

  • Urgent Care Clinic/Center
  • Affton, MO
  • NPI 1073171260
  NPD (past)

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424131200000",
    "number": "1467425215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 HAMACHER ST",
            "address_2": "SUITE 102",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981592",
            "telephone_number": "618-939-3939",
            "fax_number": "618-939-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 HAMACHER ST",
            "address_2": "SUITE 102",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981592",
            "telephone_number": "618-939-3939",
            "fax_number": "618-939-3941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "JAY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2015-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036 081291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036081291",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ginny M Peter, CPNP
• Olivia Peterson, RSA
• Yvonne Petito, MA, LSW
• Rabecca Phegley, M.S. CCC-SLP
• Katie Phelps, RSA
• Ann Elizabeth Pitcavage, MHP
• Stacie S Pleimann, PTA
• Jennifer Pluemer, RSA
• Jill Elizabeth Polovich
• Deanna Pratt

• Family Medicine Physician in Waterloo, IL
• Providers in Waterloo, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; 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.