Individual provider Active NPI

Jacob Perkins, DPM

  • Foot & Ankle Surgery Podiatrist
  • Champaign, IL
National Provider Identifier
1831752955
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016006027 Issued in IL
Practice address
2300 S 1St St
Champaign, IL 61820-7661
Phone
(217) 383-9400
Fax
(217) 383-9694
NPI assigned
Apr 15, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 016006027 IL Primary
Orthopaedic Surgery Physician 207X00000X 36.004056 OH
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2300 S 1St St
Champaign, IL 61820-7661

Mailing address

2300 S 1St St
Champaign, IL 61820-7661

Other practice location 1

350 W Wilson Bridge Rd Ste 200
Worthington, OH 43085-2591
Phone (614) 505-8990

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230822001959 IL Practitioner - Podiatry 8729469549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

2300 S 1St St
Champaign, IL 61820-7661
Phone (217) 383-9400

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

  • Carle Foundation Hospital Hospital, Urbana, IL, CCN 140091

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Care Incorporated CurrentSince Aug 8, 2023 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

2300 S 1st St
Champaign, IL 61820
Phone (217) 383-9400

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: jacob.perkins.1@23107.direct.athenahealth.com
  • Direct secure messaging: jacob.perkins.p1@direct.beaconortho.nextgenshare.com
  • Direct secure messaging: jperkinsdpm378246@carlehiedirect.net

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1831752955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 S 1ST ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 S 1ST ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207661",
            "telephone_number": "217-383-9400",
            "fax_number": "217-383-9694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 W Wilson Bridge Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Worthington",
            "state": "OH",
            "postal_code": "430852591",
            "country_code": "US",
            "telephone_number": "614-505-8990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "JACOB",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-15",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016006027",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "36.004056",
            "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 Champaign, IL

Sources for this page

Verify at the official NPI Registry.