JACINDA ANNE CORNICK (PA) – Medical Physician Assistant, NPI 1124121371
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
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Provider Addresses for JACINDA ANNE CORNICK (PA)
6501, North Sheridan Road, Keller, Peoria, Peoria County, Illinois, 61614, United States
PEORIA, IL 616142932
Phone: (309) 692-8110
Fax: (309) 692-8673
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $224.
Total Amount is formed as General ($224) + Research ($0) + Ownership ($0) = $224.
Last reported payment date: 2024-11-19 • Largest payer in this snapshot: Amgen Inc. ($118).
Total Amount
$224
General + Research + Ownership
Payments
3
Total payment records
General Amount
$224
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Amgen Inc. | $118 |
| Medtronic, Inc. | $55 |
| Radius Health, Inc. | $51 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-09-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050909000479 | I | Physician Assistant | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 63 | 54 | $0 |
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 28 | 20 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 23 | 21 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 61614)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| - | IL | |
| - | TN | |
| - | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| Physician Assistant | MO | |
| - | IL |
Reviews
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