Jacob Daniel Wengert, DC, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209023063 Issued in IL

Practice address

9515 Holy Cross LN Ste 175
Breese, IL 62230-3618

Phone

(618) 526-8430

NPI assigned

Jan 27, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

HSHS Medical Group IncGroup PAC ID 5092857821, 212 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Josephs Hospital Hospital, Breese, IL, CCN 140145
• HSHS St Elizabeth'S Hospital Hospital, O Fallon, IL, CCN 140187
• HSHS Holy Family Hospital Inc Hospital, Greenville, IL, CCN 140137
• SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Merit-based Incentive Payment System (MIPS)

Final score

94.81 of 100Reported as apm

Quality

85.98

Promoting interoperability

100

Improvement activities

40

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwengert343073@ewd.direct.hshs.org

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.

• HSHS Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1962644807
  Medicare reassignment Care Compare group NPD
• HSHS Medical Group Inc

  • Rural Health Clinic/Center
  • Dieterich, IL
  • NPI 1033841192
  NPD
• HSHS Medical Group Inc

  • Rural Health Clinic/Center
  • Rushville, IL
  • NPI 1487719480
  NPD (past)

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

• HSHS Holy Family Hospital Inc

  • General Acute Care Hospital
  • Greenville, IL
  • NPI 1205850690
  Care Compare affiliation
• St Elizabeths Hospital of the Hospital Sisters of the Third Order

  • General Acute Care Hospital
  • O Fallon, IL
  • NPI 1629057302
  Care Compare affiliation
• St Josephs Hospital Breese of the Hospital Sisters of the Third Orde

  • Rural Health Clinic/Center
  • Breese, IL
  • NPI 1013002658

  Hospital

  Care Compare affiliation
• St Josephs Hospital Breese of the Hospital Sisters of the Third Orde

  • General Acute Care Hospital
  • Breese, IL
  • NPI 1457319154
  Care Compare affiliation
• SSM Select Rehab St Louis LLC

  • Rehabilitation Hospital
  • Richmond Heights, MO
  • NPI 1659511988

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1689097768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9515 HOLY CROSS LN STE 175",
            "city": "BREESE",
            "state": "IL",
            "postal_code": "622303618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9515 HOLY CROSS LN STE 175",
            "city": "BREESE",
            "state": "IL",
            "postal_code": "622303618",
            "telephone_number": "618-526-8430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12860 Troxler Ave",
            "address_purpose": "LOCATION",
            "city": "Highland",
            "state": "IL",
            "postal_code": "622492898",
            "country_code": "US",
            "telephone_number": "618-641-5803",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17 Ginger Creek Mdws",
            "address_purpose": "LOCATION",
            "city": "Glen Carbon",
            "state": "IL",
            "postal_code": "620343508",
            "country_code": "US",
            "telephone_number": "618-656-9777",
            "fax_number": "618-656-1249",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "108 W US Highway 40",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "IL",
            "postal_code": "622941836",
            "country_code": "US",
            "telephone_number": "618-667-1800",
            "fax_number": "618-667-1802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "159 E McArthur Dr",
            "address_purpose": "LOCATION",
            "city": "Bethalto",
            "state": "IL",
            "postal_code": "620101918",
            "country_code": "US",
            "telephone_number": "618-258-7504",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4804 S State Route 159 Ste 10",
            "address_purpose": "LOCATION",
            "city": "Glen Carbon",
            "state": "IL",
            "postal_code": "620341904",
            "country_code": "US",
            "telephone_number": "618-391-5080",
            "fax_number": "618-205-3569",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5036 N Illinois St Ste 5",
            "address_purpose": "LOCATION",
            "city": "Fairview Heights",
            "state": "IL",
            "postal_code": "622083417",
            "country_code": "US",
            "telephone_number": "618-671-6800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1103 Belt Line Rd",
            "address_purpose": "LOCATION",
            "city": "Collinsville",
            "state": "IL",
            "postal_code": "622344368",
            "country_code": "US",
            "telephone_number": "618-344-2273",
            "fax_number": "618-344-3034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENGERT",
        "first_name": "JACOB",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DC, FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-27",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209023063",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209023063",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwengert343073@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "9515 Holy Cross Ln Ste 175",
            "city": "Breese",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622303618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joshua Robert Vaughan, DNP, CRNA
• Nicole Vetter, APN
• Meaghan Brittany Weedon, DPT
• Karen Elizabeth Welling, E.I.
• James Henry Wells, D.O.
• Amber Rose White, PTA
• Kay Williamson, CRNA
• Saundra Elaine Winterrowd, FNP-BC
• WP-Arc St. James Holdings, LLC
• Emma Leigh Wuest

• Nurse Practitioner in Breese, IL
• Providers in Breese, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.