Jessica Jackson, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

085.005695 Issued in IL

Practice address

330 Madison St Ste 104
Joliet, IL 60435-6572

Phone

(815) 725-3440

NPI assigned

Oct 12, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Stoeberl Former name

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Morris HospitalGroup PAC ID 1850372459, 115 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Morris Hospital & Healthcare Centers Hospital, Morris, IL, CCN 140101

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.

• Morris Hospital

  • General Practice Physician
  • Morris, IL
  • NPI 1558466268
  Medicare reassignment Care Compare group NPD
• Morris Hospital

  • Health Service Clinic/Center
  • Morris, IL
  • NPI 1376658658
  NPD

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

• Morris Hospital

  • General Acute Care Hospital
  • Morris, IL
  • NPI 1649370057
  Care Compare affiliation

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1780055285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 MADISON ST STE 104",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356572",
            "telephone_number": "815-725-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MADISON ST STE 104",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356572",
            "telephone_number": "815-725-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-12",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085.005695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "STOEBERL",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• J.E. Bertolini MD, S.C.
• J.E.Bertolini ,M.D. SC.
• Nabil Jaber, MD
• Laura Jackman
• Michael Jacksa, LCPC
• Kennedi D Jackson
• Keri Alyse Jackson
• Shea Lynn Jacobs
• Zarifa Jadallah
• Tahir Jaffery, PA

• Surgical Physician Assistant in Joliet, IL
• Providers in Joliet, IL by specialty
• Surgical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.