Jeffrey Benjamin Miessau, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3800 Issued in TN

Practice address

7707 N Knoxville Ave Ste 200
Peoria, IL 61614-2020

Phone

(309) 308-5050

Fax

(309) 308-5095

NPI assigned

Apr 8, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osf Multi-Specialty Group 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527

  IL

  Medicare reassignment Care Compare group NPD
• Saint Francis Medical Center

  • Physical Medicine & Rehabilitation Physician
  • Peoria, IL
  • NPI 1023062312

  IL

  Medicare reassignment
• Central Illinois Pathology, SC

  • Anatomic Pathology & Clinical Pathology Physician
  • Peoria, IL
  • NPI 1114970761
  NPD
• Saint Francis Medical Center

  • Neurology Physician
  • Peoria, IL
  • NPI 1154370195
  NPD
• Saint Francis Medical Center

  • Home Health Agency
  • Peoria, IL
  • NPI 1346281425
  NPD
• Saint Francis Medical Center

  • Nurse Practitioner
  • Peoria, IL
  • NPI 1962456764

  Physician Assistant

  NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1689137671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33043",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379303043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7707 N KNOXVILLE AVE STE 200",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616142020",
            "telephone_number": "309-308-5050",
            "fax_number": "309-308-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIESSAU",
        "first_name": "JEFFREY",
        "middle_name": "BENJAMIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-08",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Midwest Pain & Spine Center, LLC
• Midwest Podiatry Group, PC
• Midwest Reproductive Care LLC
• Midwest Urological Group, LTD.
• Midwest Urological Group, LTD.
• Keely Renee Mihavics, PHARMD
• John Ambrose Mihelcic, MD
• Teaghan Mihelcic, PA-C
• Jahnavi Mikkilineni, MBBS
• Amanda Christine Miklavcic, DNP PNP-AC

• All providers in Peoria, IL
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; 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.