Individual provider Active NPI

Herbert James Huston, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Centralia, IL
National Provider Identifier
1942201330
Registry record updated May 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-001637 Issued in IL
Practice address
404 N Pleasant Ave
Centralia, IL 62801-3006
Phone
(618) 339-9872
Fax
(618) 533-6816
NPI assigned
Aug 9, 2005
Last updated
May 15, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-001637 IL Primary

Addresses

Primary practice location

404 N Pleasant Ave
Centralia, IL 62801-3006

Mailing address

404 N Pleasant Ave
Centralia, IL 62801-3006
Phone (618) 339-9872

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050311000167 IL Practitioner - Physician Assistant 2264486364 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Services Corporation of Southern Illinois IncGroup PAC ID 9234022567, 120 clinicians

Practice addresses (Care Compare)

1003 E McCord St
Centralia, IL 62801-3345
Phone (618) 436-6633

2 Good Samaritan Way
Suite 320
Mount Vernon, IL 62864-2408
Phone (618) 899-1944

602 S 42ND St
Mount Vernon, IL 62864-6264

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1014COMDClinical Psychologist
085-001637ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Irvington Township Rural Health Clinic LLC Past Accepting new patients
Front Range Emergency Specialists, PC Past Accepting new patients
Marion Emergency Physicians, LLC Past Accepting new patients
Jerry L. Beguelin, MD, PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: hhuston92335@direct-ehr-ssmhc.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368576000000",
    "number": "1942201330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 N PLEASANT AVE",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013006",
            "telephone_number": "618-339-9872",
            "fax_number": "618-533-6816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N PLEASANT AVE",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013006",
            "telephone_number": "618-339-9872",
            "fax_number": "618-533-6816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSTON",
        "first_name": "HERBERT",
        "middle_name": "JAMES",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2013-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-001637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, IL

Sources for this page

Verify at the official NPI Registry.