Jacob D Sillaman, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

50004125 Issued in OH

Practice address

1380 E Stroop Rd
Kettering, OH 45429-4926

Phone

(937) 294-4356

Fax

(937) 297-2381

NPI assigned

Sep 17, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
• Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
• Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239
• Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360
• Kettering Health Greene Memorial Hospital, Xenia, OH, CCN 360026

Merit-based Incentive Payment System (MIPS)

Final score

81.34 of 100Reported as group

Quality

63.67

Promoting interoperability

100

Improvement activities

40

Cost

74.14

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.

• Kettering Independent Medical Group Inc

  • Orthopaedic Surgery Physician
  • Miamisburg, OH
  • NPI 1629387865
  Medicare reassignment Care Compare group
• Alliance Physicians Inc

  • Family Medicine Physician
  • Kettering, OH
  • NPI 1437125572
  Medicare reassignment NPD
• Alliance Physicians Inc

  • Reproductive Endocrinology Physician
  • Kettering, OH
  • NPI 1578824033
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

• Beavercreek Medical Center

  • General Acute Care Hospital
  • Beavercreek, OH
  • NPI 1760764849
  Care Compare affiliation
• Dayton Osteopathic Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1053339507
  Care Compare affiliation
• Greene Memorial Hospital Inc

  • General Acute Care Hospital
  • Xenia, OH
  • NPI 1255317848
  Care Compare affiliation
• Kettering Medical Center

  • General Acute Care Hospital
  • Kettering, OH
  • NPI 1043233984
  Care Compare affiliation
• Kettering Medical Center

  • General Acute Care Hospital
  • Miamisburg, OH
  • NPI 1316966518
  Care Compare affiliation

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1902208309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 E STROOP RD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454294926",
            "telephone_number": "937-293-3486",
            "fax_number": "937-293-3605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 E STROOP RD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454294926",
            "telephone_number": "937-294-4356",
            "fax_number": "937-297-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILLAMAN",
        "first_name": "JACOB",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-17",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50004125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0110639",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1380 E Stroop Rd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454294926",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsillaman531904@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "1380 E Stroop Rd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454294926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Haven Sidell
• Christa Siebenburgen, M.D.
• Aaron Joseph Siefker, CCP
• Steven C. Sierschula, DDS
• Jamie Siesel, D.O.
• Alexandra Sillato
• Sandra K Simi
• Martin Bruce Simmons, OD
• Catherine L Simon, P.T.
• Gail Marian Simpson, PCC-S

• Medical Physician Assistant in Kettering, OH
• Providers in Kettering, OH by specialty
• Medical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.