JACOB M MONSIVAIS (NPI# 1043520869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043520869 |
| Entity Type | Individual |
| Full Name | JACOB M MONSIVAIS |
| Credential | PA-C |
| Practice Address |
751 N Rutledge St Ste 3100 Springfield IL 62702-4968 |
| Mailing Address |
Po Box 19643 Springfield IL 62794-9643 |
| Practice Telephone | 2175458000 |
| Practice Fax Number | 2175457363 |
| Mailing Telephone | 2175458000 |
| Mailing Fax Number | 2175457363 |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2018-09-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 085-003841 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085-003841 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
751 N RUTLEDGE ST STE 3100 |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-4968 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154513687 | Fazeel Mukhtar Siddiqui | Psychiatry & Neurology | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2007-08-17 |
| 1578112363 | Amanda Graham | Nurse Practitioner | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2019-09-05 |
| 1912562109 | Katie D Hartman | Nurse Practitioner | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2019-05-03 |
| 1528440724 | Jordan Leigh Sestak | Internal Medicine | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2015-06-24 |
| 1174934269 | Charlyn Fargo Ware | Dietitian, Registered | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2014-05-12 |
| 1811322209 | Nicole Lynn Atwood | Nurse Practitioner | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2013-09-04 |
| 1184979551 | Bilal Butt | Psychiatry & Neurology | 751 N Rutledge St Ste 3100, Springfield, IL 62702 | 2012-07-20 |
| 1669784559 | Hesham A Allam | Psychiatry & Neurology | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2010-07-08 |
| 1790923951 | Nassir Hassan Monim Mansour | Neurological Surgery | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2009-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871122168 | Alexandra Emmanuelle Rochman | Physician Assistant | 54 W Crystal Brook Dr, Springfield, MA 01118-1946 | 2020-04-07 |
| 1740740737 | Western New England University | Physician Assistant | 215 Wilbraham Road, Springfield, MA 01119 | 2019-03-25 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| 1770850216 | Lauren Jennifer Navas | Physician Assistant | 100 River St Ste 2, Springfield, VT 05156-2930 | 2011-11-29 |
| 1295885168 | Jacqueline Kernaghan | Physician Assistant | 723 Saxer Ave, Springfield, PA 19064-3503 | 2007-01-11 |
| 1295746733 | Gwen Wright | Physician Assistant | 194 W Sproul Rd, Suite 105, Springfield, PA 19064-2027 | 2006-08-10 |
| 1164490710 | Stacie L Pierce | Physician Assistant | 3721 W El Castile St, Springfield, MO 65807-5431 | 2006-03-09 |
| 1245206432 | Annette K Bates | Physician Assistant | 819 Worcester St Ste 3, Springfield, MA 01151-1056 | 2006-02-27 |
| 1518947159 | Louis Patrick Favata | Physician Assistant | 140 High St., Springfield, MA 01199 | 2006-01-19 |
| 1649257031 | Scott D Rubin | Physician Assistant | 3400 Main Street, Springfield, MA 01107-1113 | 2005-12-27 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
Please comment or provide details below to improve the information on JACOB M MONSIVAIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.