Individual provider Active NPI

Meghan Nicole Jurgaitis, PA-C

  • Physician Assistant
  • Dixon, IL
National Provider Identifier
1568962009
Registry record updated Feb 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085006512 Issued in IL
Practice address
1672 S Galena Ave
Dixon, IL 61021-9611
Phone
(866) 547-1417
NPI assigned
Feb 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085006512 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X IL
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1672 S Galena Ave
Dixon, IL 61021-9611

Mailing address

486 S Peace Rd
Sycamore, IL 60178-1655
Phone (630) 677-7555

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180315001486 IL Practitioner - Physician Assistant 6709148562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Rush Medical College of Rush University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

1663 Belvidere Rd
Belvidere, IL 61008-9306
Phone (815) 544-0040

1672 S Galena Ave
Dixon, IL 61021-9611
Phone (815) 564-2663

3475 S Alpine Rd
Rockford, IL 61109-2604
Phone (815) 874-8000

4211 N Cicero Ave
Chicago, IL 60641-1651
Phone (773) 794-1000

6595 E State St
Rockford, IL 61108-2542
Phone (815) 226-1300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pic Wisconsin SC PastSince Sep 25, 2019 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519084800000",
    "number": "1568962009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "486 S PEACE RD",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601781655",
            "telephone_number": "630-677-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1672 S GALENA AVE",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610219611",
            "telephone_number": "866-547-1417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURGAITIS",
        "first_name": "MEGHAN",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006512",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

Verify at the official NPI Registry.