Individual provider Active NPI

Jessica Dejaynes, CRNA

  • Certified Registered Nurse Anesthetist
  • Galesburg, IL
National Provider Identifier
1548714041
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209014822041403022 Issued in IL
Practice address
2642 Lincoln Park Dr
Galesburg, IL 61401-1120
Phone
(309) 368-0439
NPI assigned
Aug 12, 2016
Last updated
Sep 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209014822041403022 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

2642 Lincoln Park Dr
Galesburg, IL 61401-1120

Mailing address

30 Hackberry Cir
Galesburg, IL 61401-1712
Phone (309) 368-0439

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170202002288 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 3971886672 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Medical Center of IllinoisGroup PAC ID 1355259714, shared by 8 NPIs, 387 clinicians

Practice addresses (Care Compare)

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-4281

Merit-based Incentive Payment System (MIPS)

Final score
84.21 of 100Reported as group
Quality
67.65
Promoting interoperability
99
Improvement activities
40
Cost
80.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
209014822041403022ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Medical Group CurrentSince Jan 1, 2026 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Dec 28, 2016 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Mar 1, 2024 Accepting new patients
Illinois Gastroenterology Group, LLC CurrentSince Mar 1, 2022 Accepting new patients
Northwest Gastroenterologists SC Current Accepting new patients
Elgin Gastroenterology SC Current Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Elgin Gastroenterology Endoscopy Center LLC Current Accepting new patients

Locations

5271 Reliable Pkwy
Chicago, IL 60686

745 Fletcher Dr
Ste 202
Elgin, IL 60123
Phone (855) 483-7362

2550 W Algonquin Rd
Lk in the Hls, IL 60156
Phone (847) 458-1246

1001 Main St
Ste 500A
Peoria, IL 61606
Phone (309) 672-4980

112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 696-9857

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1470960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1548714041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HACKBERRY CIR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011712",
            "telephone_number": "309-368-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2642 LINCOLN PARK DR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011120",
            "telephone_number": "309-368-0439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJAYNES",
        "first_name": "JESSICA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-12",
        "last_updated": "2020-09-28",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209014822041403022",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.