Jacob Blasingame, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085007530 Issued in IL

Practice address

1000 Medical Center Dr
Monticello, IL 61856-2116

Phone

(217) 762-6241

Fax

(217) 762-1702

NPI assigned

Feb 3, 2020

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

Electronic endpoints 1

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.

• Kirby Medical Center

  • Family Medicine Physician
  • Monticello, IL
  • NPI 1386635373

  IL

  Medicare reassignment Care Compare group NPD
• Kirby Medical Center

  • Community/Retail Pharmacy
  • Monticello, IL
  • NPI 1568074714
  Care Compare group NPD
• Kirby Medical Center

  • Rural Health Clinic/Center
  • Monticello, IL
  • NPI 1558527259
  Care Compare group NPD (past)
• Kirby Medical Center

  • Skilled Nursing Facility
  • Monticello, IL
  • NPI 1437140027
  Care Compare group
• Kirby Medical Center

  • Community/Retail Pharmacy
  • Monticello, IL
  • NPI 1437711140
  Care Compare group
• Kirby Medical Center

  • Rural Health Clinic/Center
  • Cerro Gordo, IL
  • NPI 1508219288
  Care Compare group
• Kirby Medical Center

  • Critical Access Hospital
  • Monticello, IL
  • NPI 1730179847
  Care Compare group
• Kirby Medical Center

  • Rural Health Clinic/Center
  • Atwood, IL
  • NPI 1740271667
  Care Compare group
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

• Kirby Medical Center

  • Land Ambulance
  • Monticello, IL
  • NPI 1598869133

  Hospital

  Care Compare affiliation
• Kirby Medical Center

  • Critical Access Hospital
  • Monticello, IL
  • NPI 1730179847

  Hospital

  Care Compare affiliation

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kirby Medical Center 80 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kirby Medical Center Hospital, Monticello, IL, CCN 141301

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jblasingame@kmc.kirbymedicalcenter.net

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1720619232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER DR",
            "city": "MONTICELLO",
            "state": "IL",
            "postal_code": "618562116",
            "telephone_number": "217-762-2115",
            "fax_number": "217-762-1542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER DR",
            "city": "MONTICELLO",
            "state": "IL",
            "postal_code": "618562116",
            "telephone_number": "217-762-6241",
            "fax_number": "217-762-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLASINGAME",
        "first_name": "JACOB",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-03",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jblasingame@kmc.kirbymedicalcenter.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 Medical Center Dr",
            "city": "Monticello",
            "state": "IL",
            "country_code": "US",
            "postal_code": "618562116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christy Barre, NP
• Tara C Beckett, LCSW
• Raymond Carl Bement, MA, LCSW
• Elizabeth Benson, MS, RDN, LDN
• Shelli Jo Billingsley, LPC
• Dawn Brazzell, APRN, FNP-BC
• Rachel Caldwell, CCC-SLP
• Carle Clinic Association, PC
• Carle Foundation Hospital
• Carle Health Care Incorporated

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.