JAN MIRIAM JACOB-WICKLAND (PA-C) – Physician Assistant, NPI 1508980541
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,854 PHYSICIAN ASSISTANT in MO
Provider Addresses for JAN MIRIAM JACOB-WICKLAND (PA-C)
1 Barnes Jewish Hospital Plz
Saint Louis, MO 631101003
Phone: (314) 454-8134
Type: Location
1054 BIG BEND STATION DR
MANCHESTER, MO 630881429
Phone: (636) 861-1102
Type: Mailing
615 S NEW BALLAS RD DEPT OF
SAINT LOUIS, MO 631418221
Phone: (314) 251-6000
Fax: (636) 386-7679
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2019-02-26
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 |
|---|---|---|---|---|
| I20190226003528 | I | Physician Assistant | MO | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 216 | 214 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 158 | 158 | $0 |
Insurance plans in this area (ZIP 63110)
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Group practice members
- 1
- 2
- 3
- 4
- 5
| Name | Specialty | State |
|---|---|---|
| Anesthesiology Assistant | MO | |
| Certified Registered Nurse Anesthetist (Crna) | MO | |
| Certified Registered Nurse Anesthetist (Crna) | MO | |
| A N E S T H E S I O L O G Y | MO | |
| A N E S T H E S I O L O G Y | MO | |
| A N E S T H E S I O L O G Y | MO | |
| Certified Registered Nurse Anesthetist (Crna) | MO | |
| Certified Registered Nurse Anesthetist (Crna) | MO | |
| Certified Registered Nurse Anesthetist (Crna) | MO | |
| Certified Registered Nurse Anesthetist (Crna) | MO |
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